阳性MR淋巴造影检测隐匿转移性淋巴结的实验研究  

Experimental Study on Positive MR Lymphography for Detecting Occult Metastatic Lymph Nodes

作　　者：吴元魁[1] 许乙凯[1] 杨慧[1] 吕国士 黄其鎏[1] 

机构地区：[1]南方医科大学南方医院放射科,广东广州510515 [2]河北张家口251医院CT室

出　　处：《实用放射学杂志》2008年第1期107-109,116,共4页Journal of Practical Radiology

摘　　要：目的初步探索皮下应用Gd-DTPA-白蛋白的阳性磁共振淋巴造影检测隐匿转移性淋巴结的价值。方法建立腘窝隐匿转移性淋巴结新西兰兔模型,分析隐匿转移性淋巴结在平扫及皮下注射0.10 mmol/肢Gd-DTPA-白蛋白后24 h时的MRI特征,并与病理检查对照。结果12只兔的腘窝隐匿转移性淋巴结模型成功建立,其淋巴结大小为(6.7±0.2)mm。平扫时隐匿转移性腘窝淋巴结表现为T1WI上等信号,T2WI上高信号,与正常淋巴结相似。Gd-DTPA-白蛋白增强24 h,正常淋巴结呈明显、均匀的强化,而隐匿转移性淋巴结呈不均匀强化,强化形式有环状(4枚淋巴结)、云絮状(3枚)和不规则偏心"充盈缺损"(3枚),另有2枚淋巴结不强化。在脂肪抑制T1WI像上淋巴管呈明亮高信号,转移性淋巴结的引流淋巴管明显迂曲扩张。结论皮下应用Gd-DTPA-白蛋白的阳性MR淋巴造影可清晰显示淋巴结和淋巴管,可用于检测隐匿转移性淋巴结。Objective To evaluate the potentials of positive MR lymphography for detecting occult metastatic lymph nodes after subcutaneous administration of lymphotropic HSA - Gd - DTPA. Methods Animal models with occult metastatic popliteal lymph node were devel- oped in 12 New - Zealand rabbits. MR images of popliteal lymph nodes were obtained before and 24 h after subcutaneous injection of HSA - Gd - DTPA at the dose of 0.10 mmol Gd per limb. The imaging results were analyzed and compared with pathological findings. Results On unenhanced images, the signal intensity of occult metastatic popliteal lymph nodes appeared as iso - intense on T1WI and hyper - intense on T2WI and could not be distinguished from those of normal nodes. After subcutaneous administration of HSA - Gd - DTPA, remarkable and homogeneous enhancement were shown in normal lymph nodes, while heterogeneous enhancing modes were demonstrated in occult metastatic lymph nodes, including ring - shaped （ 4 nodes） , cloud - like patterns （ 3 nodes） and irregular eccentric filling defect （ 3 nodes） respectively, and two matstatic nodes showed no enhancement. And the draining lymphatic vessels of metastatic nodes, remarkably high signal on HSA - Gd -DTPA -enhanced fat supressed T1WI images, appeared significantly dilated and tortuous. Conclusion The potentials of positive MR lymphography after subcutaneous administration of HSA - Gd - DTPA seems promising in detecting occult metastatic lymph nodes specifically because this technique faciliates in depicting both lymph nodes and lymphatic vessels.

关 键 词：钆 造影剂 动物实验 淋巴结 肿瘤 磁共振成像 

分 类 号：R-332[医药卫生] R733.4