颈部恶性肿瘤转移淋巴结与炎性淋巴结的MRI鉴别诊断

ＭＲＩ（磁共振成像）用来鉴别恶性肿瘤转移的淋巴结和炎性淋巴结，尚未有一个明确的标准。本研究对２４例颈部肿瘤转移淋巴结和１４例颈部炎性淋巴结行ＭＲＩ检查。结果表明：颈部恶性肿瘤转移淋巴结的ＭＲＩ上，Ｔ１加权为均匀略低和等信号，Ｔ２加权表现为不均匀的略高信号与高信号混合。转移淋巴结轮廓清晰，周围可出现不完全环状脂肪增生带，而炎性淋巴结在Ｔ１和Ｔ２加权上分别为：等信号和略高信号，且周边欠清晰，边缘脂肪模糊。至目前为止，ＭＲＩ可被视为鉴别上述两者的一种有效方法。

THE DIFFERENTIAL DIAGNOSIS OF MRI BETWEEN METASTATIC AND INFLAMMATORY CERVICAL LYMPH NODES

One of the biologic characteristic the malignant tumor in head and neck is its frequent occurance of cervical lymph node metastasis. It is not easy to differentially diagnose metastatic lymph nodes and inflammatory lymph nodes. Formation of image of MR bases on chemical changing of the proton and it environment aronnd tissue, thus finding probably the early pathological changes of tissue. The authors attempted to distinguish metastatic lymph nodes from inflammatory lymph nodes,38 patients with cervical enlarged lymph nodes were scanned by MR, analysed the manifestation of nodes on T 1WI and T 2WI. The result reveals metastatic lymph nodes show iso-hypo or iso intensity on T 1WI, hyper on T 2WI, and inflammatory nodes show iso intensity in T 1WI, iso-hyper on T 2WI. The margins of metastatic lymph nodes are smooth and well delineated; besides, the capsula (hypo intensity) of the nodes and the tissue edema around nodes are manifested, these of inflammatory lymph nodes are not clear. It may is suggested MR has great potential in distinguishing metastatic lymph nodes from inflammatory lymph nodes because of its excellent soft tissue contrast resolution.