摘要
目的探讨MRI表观弥散系数(ADC)在颈部结核性肿大淋巴结诊断治疗中的临床应用价值。方法选择52例颈部肿大淋巴结患者,其中男性25例,女性27例;年龄9~84岁,中位年龄51岁;结核性肿大淋巴结17例,炎症性肿大淋巴结19例,肿瘤性肿大淋巴结16例。对患者行细针穿刺病理检查并分组,采用上海联影1.5 T MRI行影像诊断。测量各组平均ADC值,并进行统计学分析。结核性肿大淋巴结患者根据3个月抗结核诊疗效果,比较其治疗前后平均ADC值变化。结果结核性肿大淋巴结组平均ADC值为(1.09±0.29)×10^(-3)mm^(2)/s,炎症性肿大淋巴结组平均ADC值为(1.27±0.39)×10^(-3)mm^(2)/s,肿瘤性肿大淋巴结组平均ADC值为(0.87±0.26)×10^(-3)mm^(2)/s。肿瘤性肿大淋巴结组与炎症性肿大淋巴结组、结核性肿大淋巴结组的ADC差异具有统计学意义(P<0.05)。炎症性肿大淋巴结组平均ADC值高于结核性肿大淋巴结组,差异无统计学意义(P>0.05)。抗结核治疗后淋巴结缩小组治疗前平均ADC值为(1.14±0.23)×10^(-3)mm^(2)/s,治疗后平均ADC值为(0.99±0.08)×10^(-3)mm^(2)/s,差异具有统计学意义(P<0.05)。淋巴结大小不变组治疗前平均ADC值(1.04±0.28)×10^(-3)mm^(2)/s,治疗后平均ADC值(0.91±0.13)×10^(-3)mm^(2)/s,差异无统计学意义(P>0.05)。淋巴结增大组治疗前平均ADC值为(1.12±0.10)×10^(-3)mm^(2)/s,治疗后平均ADC值为(1.13±0.22)×10^(-3)mm^(2)/s,差异无统计学意义(P>0.05)。结论ADC值有助于鉴别诊断颈部结核性肿大淋巴结、炎症性肿大淋巴结及肿瘤性肿大淋巴结,还可用于评估颈部淋巴结核的抗结核治疗效果,为临床诊断治疗提供参考依据。
Objective To evaluate the clinical value of MRI apparent diffusion coefficient(ADC)in diagnosis and treatment of cervical tuberculous lymph nodes.Methods A total of 52 patients with enlarged cervical lymph nodes were enrolled,which included 25 males and 27 females,aged 9-84 years old with median age of 51 years old.There were 17 cases of tuberculous enlarged lymph nodes,19 of inflammatory enlarged lymph nodes and 16 of neoplastic enlarged lymph nodes.All of them were performed with fine needle aspiration and grouped;the 1.5 T MRI was used for imaging diagnosis.The average ADC values of each group were measured and statistically analyzed.The average ADC values of patients with tuberculous enlarged lymph nodes before and after treatment were compared according to the effect of anti-tuberculosis treatment for 3-month.Results The average ADC value of tuberculous enlarged lymph node group was(1.09±0.29)×10^(-3) mm^(2)/s,inflammatory enlarged lymph node group was(1.27±0.39)×10^(-3) mm^(2)/s,neoplastic enlarged lymph node group was(0.87±0.26)×10^(-3) mm^(2)/s.The ADC value of neoplastic enlarged lymph node group was statistically significantly higher than that of inflammatory enlarged lymph node group and tuberculous enlarged lymph node group(P<0.05).The average ADC value of inflammatory enlarged lymph node group was higher than that of tuberculous enlarged lymph node group,and the difference was no statistically significant(P>0.05).After anti-tuberculosis treatment,the average ADC value of lymph node shrank group was(0.99±0.08)×10^(-3) mm^(2)/s,which was statistically significantly lower than before treatment[(1.14±0.23)×10^(-3) mm^(2)/s](P<0.05).In lymph node size unchanged group,there was no significant differences in average ADC value before and after treatment[(1.04±0.28)×10^(-3)mm^(2)/s vs(0.91±0.13)×10^(-3)mm^(2)/s.P>0.05].In lymph node enlargement group,the average ADC value before and after treatment were(1.12±0.10)×10^(-3) mm^(2)/s and(1.13±0.22)×10^(-3) mm^(2)/s,respectively,and there was no
作者
朱佩玉
杨月
ZHU Pei-yu;YANG Yue(Department of Radiology,Nantong Hospital Affiliated to Shanghai University,Nantong 226000,Jiangsu,China)
出处
《生物医学工程与临床》
CAS
2024年第2期240-244,共5页
Biomedical Engineering and Clinical Medicine
基金
南通市科技局指导性课题(JCZ20186)
南通市科技局级青年A课题(QA2021049)。
