鼻咽癌颈部淋巴结转移MR多b值DWI成像研究分析
作者: |
1林成武,
2谢宝君
1 昆山宗仁卿纪念医院放射科,江苏 昆山 215300 2 武汉大学人民医院放射科,武汉 430060 |
通讯: |
谢宝君
Email: lcw197501@163.com |
DOI: | 10.3978/j.issn.2095-6959.2016.08.027 |
摘要
目的:研究在鼻咽癌(nasopharyngeal carcinoma,NPC)颈部淋巴结转移的评价中1.5T MR多b值扩散加权成像(diffusion weighted imaging,DWI)的应用价值。方法:对良性淋巴结增大病人15例及鼻咽癌病人37例进行常规MR及多b值DWI检查,对不同b值的DWI图像质量进行比较。对不同b值下良、恶性淋巴结ADC值的ROC曲线进行记录。结果:b=800 s/mm2时鼻咽部变形小,图像背景抑制充分,伪影少,周围软组织与病灶具有较好的对比度,小淋巴结显示清楚;鼻咽癌、良性淋巴结及颈部转移性淋巴结的ADC值随着b值增大均呈下降趋势,8种b值下转移性淋巴结与鼻咽癌原发灶向比较,ADC值差异无统计学差异(P>0.05)。而良性淋巴结与转移性淋巴结相比较,ADC值差异均有统计学差异(P<0.05);b=800 s/mm2时对良恶性淋巴结的鉴定效果最好,灵敏度为100%,特异度为83.2%。结论:1.5T MR扩散加权成像(DWI)技术能有效鉴别淋巴结性质,b值取800 s/mm2时,DWI图像具有较好的质量,且对良恶性淋巴结的鉴定诊断效果最好,可在临床鼻咽癌颈部淋巴结转移的诊断中推广应用。
关键词:
鼻咽癌
颈部淋巴结
扩散加权成像
价值
Cervical lymph node metastasis in nasopharyngeal carcinoma MR b value DWI imaging study
CorrespondingAuthor: XIE Baojun Email: lcw197501@163.com
DOI: 10.3978/j.issn.2095-6959.2016.08.027
Abstract
Objective: To study the value of MR 1.5T diffusion weighted imaging (DWI) in the evaluation of cervical lymph node metastasis in nasopharyngeal carcinoma (NPC). Methods: 37 cases of benign lymph node enlargement and 15 patients with nasopharyngeal carcinoma were examined by routine MR and multi DWI b, and the quality of DWI images with different b values were compared. ADC curves of benign and malignant lymph nodes with different b values were recorded. The ROC curves were recorded. Results: Avanto nasopharynx deformation small, the image background is suppressed sufficiently and artifacts less, better contrast with surrounding soft tissue and lesion and lymph node showed clearly; nasopharyngeal carcinoma and benign lymph nodes and neck metastasis lymph node of ADC value along with the increasing of b value showed a downward trend, 8 kinds of b value metastasis lymph nodes in nasopharyngeal carcinoma and primary tumor to the comparison, the difference of the ADC values of no statistical difference (P>0.05). The benign lymph nodes and metastatic lymph nodes were compared, ADC values were statistically different (P<0.05); b=800 s/mm2 was the best for the identification of benign and malignant lymph nodes, the sensitivity was 100%, specificity was 83.2%. Conclusion: 1.5T MR diffusion weighted imaging (DWI) technology can effective identification of lymph nodes, when b=800 s/mm2, DWI images has good quality, and the diagnosis of benign and malignant lymph nodes effect best, it is worth widely applying in the diagnosis of cervical lymph node metastasis of nasopharyngeal carcinoma (NPC).