腹部淋巴结病变80例应用磁共振联合弥散加权成像定性诊断临床价值分析  

Clinical value of qualitative diagnosis of abdominal lymph node lesion with MRI combined with DWI

作　　者：张祯铭[1] 王艳晶[1] 柳林[1] 赵敬堃 ZHANG Zhenming;WANG Yanjing;LIU Lin;ZHAO Jingkun(Department of Radiology,China-Japan Friendship Hospital,Jilin University,Changchun,Jilin 130000,China)

机构地区：[1]吉林大学中日联谊医院放射科,吉林长春130000

出　　处：《安徽医药》2018年第10期1916-1918,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨腹部淋巴结病变患者采用常规磁共振(MRI)联合弥散加权成像(DWI)定性诊断临床价值。方法选取吉林大学中日联谊医院2015年8月至2016年8月确诊为腹部淋巴结病变的患者80例,分为恶性组(52例)与良性组(28例),比较与分析两组患者间MRI影像学表现特征,并对MRI、DWI及联合MRI与DWI定性诊断价值进行评价分析。结果恶性组:52例患者中,单发者16例、多发者36例,病变位置主要为肝门和肝胃间隙及门腔间隙等区域;形态:单发者主要为圆形或类圆形;多发者主要为不规则分叶状或团块状或块状,且周围脂肪间隙模糊。良性组:单发者22例、多发者6例,病变位置主要为肝门区域和门腔间隙及肠系膜根部或周围;形态:单发者主要为圆形或类圆形;多发者中4例为粘连并融合成块且周围脂肪间隙模糊,2例表现为串珠状且边界清晰。恶性组囊变率为78.85%与良性组64.29%比较,χ~2=1.99,P=0.153;环形强化率48.08%,明显高于良性组14.29%,χ~2=8.99,P=0.000。联合MRI与DWI定性诊断准确率明显高于单独MRI或DWI定性诊断准确率,P<0.05。良性组淋巴结ADC值平均为(1.691±0.298)×10~3mm^2·s^(-1),明显高于恶性组(1.048±0.192)×10~3mm^2·s^(-1),t=11.71,P=0.00。结论联合磁共振与弥散加权成像对临床定性诊断腹部淋巴结病变具有重要价值。Objective To evaluate the clinical value of routine magnetic resonance imaging（ MRI） combined with diffusion weighted imaging（ DWI） in patients with abdominal lymphadenopathy. Methods Eighty patients with abdominal lymph node lesions diagnosed by histological examinations in China-Japan FriendshipHospital from August 2015 to August 2016 were seleCTed as the subjeCTs. The patients were assigned into malignant group（ 52 cases） and benign group（ 28 cases）. The MRI imaging features were analyzed and compared between the two groups,and the qualitative diagnostic values of MRI,DWI and MRI combined with DWI were evaluated. Results In malignant group,solitary lesion was found in 16 cases and multiple lesions in 36 cases. The locations of the lesions were mainly in the hilum,hepatogastric space or the portacaval space. The shapes of the solitary lesions were mainly round or round-like,while the shapes of the multiple lesions were mainly irregularly lobulated,lump or massive,and the surrounding fat gap blurred. In benign group,solitary lesion was found in 22 cases and multiple lesions in 6 cases. The main locations of the lesions were in the hilum,the portacaval space,the root of the mesentery or its surrounding tissues. The shapes of the solitary lesions were mainly round or round-like,while the shapes of the multiple lesions in 4 cases were adhesive,massive together with blurred surrounding fat gap,and the shapes of the multiple lesions in other 2 cases were beaded with clear boundary. The rate of malignancy was 78. 85% in malignant group and 64. 29% in benign group（ χ~2= 1. 99,P = 0. 153）; ring enhancement rate in malignant group（ 48. 08%） was significantly higher than that of benign group（ 14. 29%）（ χ~2= 8. 99,P = 0. 000）. The diagnostic accuracy of combined MRI and DWI was significantly higher than that of MRI or DWI alone（ P〈0. 05）. The ADC value of the lymph nodes in benign group [（ 1. 691 ± 0. 298） × 10~3 mm^2·s^（-1）],was significantly higher than that of malignant

关 键 词：淋巴系统疾病 腹部 弥散磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R572[医药卫生—诊断学]