中国临床解剖学杂志 ›› 2010, Vol. 28 ›› Issue (1): 65-.

• 断层影像解剖 • 上一篇    下一篇

磁共振全身弥散成像对盆腔淋巴结检测的价值初探

赵小春, 孙西河, 王 滨, 孙世杭, 董 鹏, 张颖颖, 管 玥, 葛艳明   

  1. 潍坊医学院附属医院影像中心, 山东  潍坊   261031
  • 收稿日期:2009-04-22 出版日期:2010-01-25 发布日期:2010-02-03
  • 通讯作者: 孙西河,教授,E-mail: sunxihe8130@163.com E-mail:zxczxc761222@126.com.
  • 作者简介:赵小春(1976-),男,山东济宁市人,在读硕士研究生,研究方向磁共振功能成像,Tel: 0536-8068959

Initial exploration of pelvic lymph node detection with MR whole-body diffusion-weighted imaging

ZHAO Xiao-chun, SUN Xi-he, WANG Bin,  et al.   

  1. Medical Imaging Center, Affiliated Hospital of Weifang Medical College, Weifang 261031, China
  • Received:2009-04-22 Online:2010-01-25 Published:2010-02-03

摘要:

        目的  探讨磁共振全身弥散成像(WB-DWI)对盆腔正常与异常淋巴结评估的应用价值。方法  对初次治疗的66例盆腔恶性肿瘤患者以及经知情同意随机抽取的30名健康人群行WB-DWI、T1加权成像(T1WI)和T2加权成像(T2WI)观测盆腔淋巴结,按解剖部位进行淋巴结计数,测量大小和ADC值并进行统计学分析。 结果  正常盆腔淋巴结在WB-DWI图像上未见显示。与T1+T2相比,WB-DWI对短轴横径<0.5 cm的盆腔淋巴结检出率是0.3%,对短轴横径0.5 ~1.0 cm的淋巴结总的检出率是94.2%。术前WB-DWI检测短轴横径≥0.5 cm的转移淋巴结与术后病理检出的吻合率是89.3%。转移性与非转移性淋巴结的ADC值相比无差异性(P>0.05)。WB-DWI发现病变淋巴结的阅片时间小于传统MR图像的阅片时间(P<0.01)。 结论  WB-DWI可以快速发现异常淋巴结,在判断盆腔淋巴结有无受累方面具有重要价值。

关键词:  , 淋巴结, 磁共振全身弥散成像, 盆腔肿瘤

Abstract:

        Objective   To explore the value of MR whole-body diffusion-weighted imaging (WB-DWI) in detecting pelvic lymph nodes.  Methods   30 cases of informed consent healthy men were selected randomly and 66 cases of pre-operative initial treatment men with pelvic malignant tumors were selected from June 2007 to November 2008 in our hospital. MR WB-DWI, T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) performed to observe the pelvic lymph nodes respectively. It was confirmed by surgery and pathology in patients with pelvic malignancies. Pelvic lymph nodes were counted and their size and ADC values were calculated according to their anatomical site.  Results   The normal pelvic lymph nodes could not show in the WB-DWI images. Contrast with T1+T2, the detection rate was 0.3% on WB-DWI sequence for pelvic lymph node whose short-axis diameter <0.5 cm, but the detection rate was 94.2% for the pelvic lymph node whose short-axis diameter ≥ 0.5 cm and <1.0 cm. The coincident rate of lymph node metastasis whose short-axis diameter ≥ 0.5cm was 89.3% between preoperative detection on WB-DWI and postoperative detection on pathology. There was no significant difference in the ADC values between metastatic and non-metastatic lymph nodes (P>0.05). Diagnostic time for the WB-DWI images was less than the time for the traditional MR images significantly (P<0.01).  Conclusions   The abnormal lymph nodes could be found quickly on WB-DWI sequence. There is a high value on WB-DWI sequence in determining pelvic lymph node involved by malignant tumors, and could be a relatively accurate method for preoperative evaluation.

Key words:  Lymph node, MR whole-body diffusion-weighted imaging, Pelvic malignant tumor

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