全身磁共振扩散加权成像正常表现及在淋巴结病变的初步应用  

Whole body MR diffusion weighted imaging：normal manifestations and initial application in lymphadenopathy

作　　者：闫明勤[1] 王嵩[1] 张世界[1] 潘嫣红[1] 赵秋枫[1] 李琼[1] 

机构地区：[1]上海中医药大学附属龙华医院放射科,上海200032

出　　处：《实用放射学杂志》2011年第11期1722-1724,1739,共4页Journal of Practical Radiology

基　　金：基金项目：上海市卫生局课题（编号：2010026）;上海市卫生局中西医结合专项课题（编号：2009ZXY012）.

摘　　要：目的探讨全身磁共振扩散加权成像（wholebodymagneticresonancediffusionweightedimaging，WBMRDWI）正常影像表现及对淋巴结病变的诊断价值。方法健康志愿者16例，经病理或临床证实的淋巴结病变患者21例，其中肿瘤性病变12例（淋巴瘤5例，肺癌伴淋巴结转移7例），系统性红斑狼疮伴良性淋巴结病变9例，所有受试者均接受WBMRDWI检查，原始图像经后处理获得3I）MIP图像并翻转屁示。总结WBMRDWI的正常表现；分别计数淋巴结个数、测量病灶的ADC值。结果正常人骨骼系统呈低一等信号，双肺、纵隔、肝脏，血管、肌肉、脂肪呈低信号。椎间柱、脊髓、颅脑、脾脏、肾脏、子宫内膜和前列腺外周带，睾丸．阴茎呈高信号。神经根及正常小淋巴结也湿示为高信号。WBMRDWI可以清楚显示淋巴结病变，良性和恶性淋巴结病变均呈高信号。淋巴瘤及良性淋巴结病变的平均AI）C值分别为（0．804±0．121）×10^-3mm^2／s、（0．974±0．133）×10^-3mm^2／s。两者间差异有统计学意义（t＝3．869，P＝0．00〈0．05）。肺癌原发灶与转移灶的平均ADC值分别为（1．218±0．118）×10^-3mm^2／s、（1．179±0．115）×10^3mm^2／s，差异无统计学意义（t=0．714，P=0．484〉0．05）。结论WBMRDWI快速、安全，对淋巴结的显示较敏感，可作为探测全身良、恶性淋巴结病变的一种可行方法。Objective To investigate the normal manifestations of whole body magnetic resonance diffusion weighted imaging（WB MR DWI） and its diagnostic value in lymphadenopathy. Methods WB MR DWI were performed in 16 healthy volunteers and 21 pa tients with lymphadenopathy confirmed by pathology and clinic, including 12 patiants with tumors（lymphoma= 5 cases, lung cancer with metastatic lymphadenopathy--7 cases）and 9 systemic lupus erythematosus（SI.E） patiants with benign lymphadenopathy. Original images were reconstructed for 3D MIP images and inverted to display. The normal manifestations of WB MR DWI were ana lyzed. The numbers of lymphadenopathy were counted and the apparent diffusion coefficient（ADC） value was measured. Results In healthy volunteers, the skeletal system showed low signal intensity to isointensity. The lung, mediastinum, liver, vessel, muscle and fat showed low signal intensity. The brain, spleen, kidney, endometrium, peripheral zone of prostate, testis, penis,intervertehral disc and spinal cord showed high signal intensity. Nerves and little nornal lymph nodes also demonstrated high signal intensity. WB MR DW1 clearly displayed lymphadenopathy. All benign and malignant lymphadenopathy showed high signal intensity. The average ADC values of lymphoma and the benign lymphadenopathy were （ 0. 804 ± 0.121 ）× 10^-3 mm^2/s and （ 0.974 ±0.133 ） × 10^-3 mm^2/s respectively and there was statistical difference （t=3. 869 , P=0. 001〈0.05 ） between them . The average ADC values of lung cancer and its metastatic lesions were （ 1. 218±0. 118 ） × 10^-3 mm^2/s and （ 1. 179±0. 115 ） × 10^-3 mm^2/s respectively , and there was no statistical difference （ t = 0. 714 , P= 0. 4842〉0.05）. Conclusion WB MR DWI examination is fast and safe,it is sensitive to display lymphadenopathy and is a feasible method to detect the whole body benign and malignant lymphadenopathy.

关 键 词：磁共振成像 扩散加权成像 全身 淋巴结 

分 类 号：R445.2[医药卫生—影像医学与核医学] R654.7[医药卫生—诊断学]