磁共振表观扩散系数对不同组织来源小肠淋巴瘤的定量诊断价值  

Significance of MRI with quantitative ADC for diagnosing small intestinal lymphoma in which cancer cells form in different tissues

作　　者：韩云鹏[1] 张琳琳[1] 尚劲 关键 HAN Yun-peng;ZHANG Lin-lin;SHANG Jin;GUAN Jian(Department of Radiology,The Third People’s Hospital of Dalian,Dalian 116037,China)

机构地区：[1]大连市第三人民医院放射科,大连116037

出　　处：《中国肿瘤临床与康复》2020年第7期850-852,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨磁共振表观扩散系数(ADC)对不同类型小肠淋巴瘤的诊断价值。方法选取2016年5月至2019年8月间大连市第三人民医院收治的经病理确诊的32例小肠淋巴瘤患者,均行磁共振扩散加权成像(DWI)检查,b值取0、700s/mm2测量病灶ADC值,绘制受试者工作特征曲线(ROC),分析ADC值对小肠淋巴瘤的诊断价值。结果弥漫大B细胞源性肿瘤肠壁不规则增厚,T2WI呈等及稍高信号,T1WI为低信号,ADC呈低或略低信号影;T细胞源性肿瘤病灶呈团块状,T2WI呈等信号,T1WI呈低信号,ADC信号较低。患者ADC值平均值为(0. 71±0. 18)×10^-3mm^2/s,弥漫性B细胞源性肿瘤患者ADC值平均值为(0. 61±0. 12)×10^-3mm^2/s,T细胞源性肿瘤ADC值平均值为(0. 97±0. 09)×10^-3mm^2/s,T细胞源性肿瘤ADC值高于弥漫性B细胞源性肿瘤,差异有统计学意义(P <0. 05)。弥漫性B细胞源性肿瘤患者T1信号比为(0. 89±0. 14),T细胞源性肿瘤T1信号比为(0. 94±0. 13),差异无统计学意义(P> 0. 05)。32例小肠淋巴瘤患者ADC值绘制ROC曲线,测得曲线下面积0. 774,即当ADC=0. 780×10^-3mm^2/s时,其诊断敏感性为56. 3%,特异性为91. 6%。结论磁共振ADC有助于弥漫大B细胞源性小肠淋巴瘤与T细胞源性小肠淋巴瘤的临床诊断,磁共振DWI可作为小肠淋巴瘤临床筛查诊断方法。Objective To investigate the value of magnetic resonance imaging( MRI) with quantitative apparent diffusion coefficient( ADC) in the diagnosis of different types of small intestinal lymphoma.Methods Thirty-two patients with small intestinal lymphoma who were treated at The Third People’s Hospital of Dalian from May 2016 to August 2019 and confirmed by pathology were selected as the study subjects.All patients were examined by diffusion weighted( DWI) MRI. The ADC value of lesions was measured at 0 and 700 s/mm^2 of b value,and the working characteristic curve( ROC) was drawn to analyze the diagnostic significance of ADC value for small intestinal lymphoma. Results Irregular thickening of intestinal wall was presented for diffuse large B-cell lymphoma. It showed slightly high signal intensity at T2-weighted imaging( T2WI) and low signal intensity at T1 WI. DWI revealed low or slightly low signal intensity on ADC.Mass-like T cell-targeting focus was seen. It showed slightly high signal intensity at T2WI and low signal intensity at T1 WI. The average ADC was( 0. 71 ± 0. 18) × 10^-3mm^2/s in the 32 patients. The average ADC was( 0. 97 ± 0. 09) × 10^-3mm^2/s for T cell-targeting focus which was higher than( 0. 61 ± 0. 12) × 10^-3mm^2/s for diffuse large B-cell lymphoma( P < 0. 05). There was no significant difference in T1 signal ratio between diffuse large B-cell lymphoma( 0. 89 ± 0. 14) and T cell-targeting focus( 0. 94 ± 0. 13,P > 0. 05).Area under ROC curves was 0. 774,which means the diagnostic sensitivity was 56. 3% and the specificity was91. 6% when ADC was 0. 780 × 10^-3mm^2/s. Conclusion MRI with quantitative ADC is helpful for the clinical diagnosis of diffuse large B-cell lymphoma and T-cell-targeting lymphoma of the small intestine.

关 键 词：表观扩散系数 小肠淋巴瘤 磁共振扩散加权成像 

分 类 号：R735.3[医药卫生—肿瘤]