摘要
目的探讨3.0T MR扩散加权成像(diffusion weighted imaging,DWI)在鉴别良恶性咽后淋巴结中的临床价值。方法收集44例伴咽后淋巴结肿大的鼻咽病变患者的临床及影像资料,所有患者均行MRI检查,根据病理活检及临床随访分为良性组13例和恶性组31例。比较DWI信号及测量表观弥散系数(apparent dispersion coefficient,ADC),采用受试者工作特征(receiver operating characteristic,ROC)曲线计算ADC值的最佳临界值及曲线下面积(area under the curve,AUC),评价其诊断效能并分析不同信号及大小恶性淋巴结ADC值的差异。结果 44例患者共65枚咽后外侧组淋巴结纳入分析,其中良性组(23枚)和恶性组(42枚)的ADC值分别为(0.833±0.095)×10^(-3) mm^(2)/s、(0.737±0.136)×10^(-3) mm^(2)/s,差异有统计学意义(P=0.004);以65枚良恶性咽后外侧组淋巴结的ADC值判断良恶性并绘制ROC,AUC为0.756,以0.769×10^(-3) mm^(2)/s作为最佳诊断临界值,诊断良恶性的敏感度为78.3%,特异度为64.3%。恶性淋巴结信号均匀组与不均匀组的ADC值分别为(0.688±0.092)×10^(-3) mm^(2)/s、(0.787±0.156)×10^(-3) mm^(2)/s,差异有统计学意义(P=0.016);恶性淋巴结最大短径≤10 mm组与>10 mm组的ADC值分别为(0.745±0.146)×10^(-3) mm^(2)/s、(0.731±0.131)×10~(-3) mm^(2)/s,差异无统计学意义(P=0.748)。结论 3.0T MR DWI的ADC值对咽后淋巴结良恶性的鉴别诊断具有重要参考意义,DWI有助于提高最大短径<5 mm的转移性咽后小淋巴结的诊断准确性。
Objective To investigate the clinical value of 3.0 T MR diffusion weighted imaging(DWI)in differentiating benign and malignant retropharyngeal lymph nodes.Methods The clinical and imaging data of 44 patients with retropharyngeal lymph nodes RLNs were collected.All of the patients underwent MRI examination,and were divided into benign group(13 cases)and malignant group(31 cases)according to pathological biopsy.The DWI signal and apparent dispersion coefficient(ADC)value were compared,and the receiver operating characteristic(ROC)curve was used to calculate the optimal critical value of ADC and area under the curve(AUC),to evaluate the diagnostic efficacy and to analyze the difference of signal and ADC value of different malignant lymph nodes.Results A total of 65 lymph nodes in the posterior lateral pharyngeal group of 44 patients were included in the analysis,the ADC values of benign group(23 nodes)and malignant group(42 nodes)were(0.833±0.095)×10^(-3) mm^(2)/s and(0.737±0.136)×10^(-3) mm^(2)/s,respectively,and the difference was statistically significant(P=0.004).The ADC value of 65 lymph nodes(both benign and malignant)were used to determine benign and malignant lymph nodes and draw ROC curve,and AUC was 0.756.With 0.769×10^(-3) mm^(2)/s as the best diagnostic cut-off value,the sensitivity for the diagnosis of benign and malignant was 78.3%,and the specificity was 64.3%.The ADC values of the malignant lymph nodes in the signal uniform group and the inhomogeneous group were(0.688±0.092)×10^(-3) mm^(2)/s and(0.787±0.156)×10^(-3) mm^(2)/s,respectively,and the difference was statistically significant(P=0.016).The ADC values of the maximum short diameter of malignant lymph nodes≤10 mm goup and>10 mm group were(0.745±0.146)×10^(-3) mm^(2)/s and(0.731±0.131)×10^(-3) mm^(2)/s,respectively,and the difference was not statistically significant(P=0.748).Conclusion The ADC value of 3.0 T MR DWI is an important reference for the differential diagnosis of benign and malignant postpharyngeal lymph nodes.Moreover
作者
梁久平
符念霞
陈惠枚
闫瑶瑶
彭华荣
宋建勋
LIANG Jiuping;FU Nianxia;CHEN Huimei;YAN Yaoyao;PENG Huarong;SONG Jianxun(Department of Radiology,the Second Affiliated Hospital,Shenzhen University,Shenzhen 518101,China)
出处
《中国癌症防治杂志》
CAS
2021年第1期81-84,共4页
CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT
基金
深圳市宝安区科技计划项目(2020JD461)。
关键词
鼻咽肿瘤
咽后淋巴结
磁共振成像
扩散成像
Nasopharyngeal neoplasm
Retropharyngeal lymph node
Magnetic resonance imaging
Diffusion weighted imaging
