MRI在良恶性淋巴结病变诊断及疗效评估中的应用  

The application of MR imaging in differentiating benign and malignant lymph node and assessing therapeutic effect

作　　者：郝彩仙[1] 刘筠[1] 钟进[1] 许亮[1] 张秀玲[1] 张煜琳 宗常青[1] 乔辉[1] 

机构地区：[1]天津市人民医院影像学部,天津300121

出　　处：《实用放射学杂志》2014年第10期1706-1709,共4页Journal of Practical Radiology

基　　金：天津市卫生局科技基金（2010KY13,2011KY19）.

摘　　要：目的：探讨背景信号抑制扩散成像（DWIBS）结合 MRI常规序列在淋巴结良恶性鉴别诊断及淋巴源性肿瘤疗效评估中的应用价值。方法48例经病理或随访证实的颈部淋巴结肿大患者行 DWIBS及常规 MRI检查,其中,83枚恶性淋巴结,79枚良性淋巴结。对16例恶性淋巴结病变患者进行放化疗后复查,比较淋巴结实质部分的 ADC 值。结果 DWIBS 序列较常规序列可发现更多的淋巴结。恶性淋巴结实质部分的 ADC值为（0.898±0.111）×10-3 mm2/s,低于良性淋巴结的 ADC值（1.043±0.106）×10-3 mm2/s,差异有统计学意义（P〈0.05）。所有恶性淋巴结病变治疗后的 ADC值为（1.205±0.121）×10-3 mm2/s,较治疗前的 ADC值（0.883±0.090）×10-3 mm2/s 明显升高,差异有统计学意义（P〉0.05）。结论 DWIBS序列在检出淋巴结方面较常规MRI序列更为敏感。ADC值在鉴别淋巴结良恶性及疗效评估方面有一定的参考价值。Objective To approach the application value of diffusion weighted imaging with background suppression （DWIBS） combined with routine MR sequence in differentiating benign and malignant lymph nodes,and assessing therapeutic effect of lympho-genic tumors.Methods 48 patients with cervical lymph node enlargement who were confirmed by pathology and follow up under-went DWIBS and routine MRI examination,malignant lymph nodes were 83,benign lymph nodes were 79.16 patients with malig-nant lymph nodes were rechecked after radiotherapy and chemotherapy,Apparent diffusion coefficient （ADC）values of the solid part for lymph nodes were compared.Results More lymph nodes can be detected in DWIBS than conventional sequence.ADC values of the solid part for malignant lymph node（0.898±0.111）×10-3 mm2/s were lower than that of benign lymph node（1.043±0.106）× 10-3 mm2/s,there was significant difference between them （P〈0.05）.ADC values of all malignant lymph nodes after treatment （1.205±0.121）×10-3 mm2/s were significantly higher than that of pretherapy （0.883±0.090）×10-3 mm2/s （P〉0.05）.Conclu-sion DWIBS could more sensitively detect lymph node than conventional MR sequence.ADC value could provide some reference values for differentiating benign and malignant lymph nodes and assessing therapeutic effect.

关 键 词：磁共振成像 背景信号抑制扩散加权成像 淋巴结 

分 类 号：R445.2[医药卫生—影像医学与核医学] R551.2[医药卫生—诊断学]