磁共振扩散加权成像及ADC值测量在淋巴结病变鉴别诊断中的价值

目的探讨磁共振扩散加权成像(DWI)以及表观扩散系数(ADC)值测量在颈部淋巴结病变鉴别诊断中的作用。方法使用GE 1.5T磁共振扫描仪及颈部相控阵线圈对30例单侧或双侧颈部淋巴结肿大患者行常规SE序列扫描,其中16例为恶性肿瘤,14例为良性病变,均经手术及病理证实。全部病例使用体线圈行SE-EPI DWI序列扫描,采用全方位扩散梯度及6个b值扫描。DWI扫描时间40~52 s。分析30例病例的DWI与ADC值特点。结果在DWI序列扫描中,良性和恶性淋巴结均呈高信号,恶性淋巴结组的平均ADC值为(0.849±0.197)×10-3mm2/s,良性淋巴结组为(1.598±0.218)×10-3mm2/s,恶性淋巴结组平均ADC值明显小于良性淋巴结组(P<0.05),两组间存在统计学差异。结论DWI对于鉴别颈部良恶性淋巴结病变是一种快速可行的技术,具有一定的临床价值。

Diffusion weighted imaging and apparent diffusion coefficient value in differential diagnosis of lymph node lesions

Objective To evaluate the role of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) in the differential diagnosis of lymph node lesions. Methods Conventional MR imaging (spin echo T1WI, T2WI and STIR) was performed in 30 patients with histologically proven malignant tumors (16) and benign lesions (14) by using GE 1.5T scanner with cervical phased array coil. Six b values (30 cases) were acquired with diffusion gradients applied in all three orthogonal directions using body coil. Images were acquired independently in each of the gradient directions (X, Y and Z). Diffusion scan time was 40-52 seconds. ADC values were measured in the lymph node lesions. Results All benign and malignant lymph nodes were visible in DWI and showed significant hyperintensity signal. The differences in mean ADC of Group malignant lymph nodes ( ×10^-3 mm²/s) and Group benign lymph nodes ( ×10^-3 mm²/s) were statistically significant (P<0.05). Conclusion Diffusion weighted imaging is a rapid and feasible method in detecting cervical lymph node lesions and shows a potential for distinguishing between benign and malignant lymph nodes.