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目的探讨全身磁共振扩散加权成像(WB MR DWI)对初诊不明原因淋巴结肿大的鉴别诊断价值。方法经病理或临床证实的初诊淋巴结病变患者78例,其中淋巴瘤31例(淋巴瘤组),肿瘤转移性淋巴结病变30例(转移性淋巴结组),炎性淋巴结17例(炎性淋巴结组),所有患者均于治疗前行WB MR DWI检查,分别记录淋巴结病变个数并测量其表观扩散系数(ADC)值,应用独立样本t检验及受试者工作特征(ROC)曲线分析每两组病变的ADC值鉴别价值。结果淋巴瘤组、转移性淋巴结组及炎性淋巴结组平均ADC值分别为(1.197±0.388)×10-3mm2/s、(1.343±0.299)×10-3mm2/s和(1.677±0.466)×10-3mm2/s,淋巴瘤与转移性淋巴结组的平均ADC值均明显小于炎性组,淋巴瘤组的平均ADC值也小于转移性淋巴结组(P<0.01),应用ROC曲线得出鉴别淋巴瘤与转移性淋巴结、淋巴瘤与炎性淋巴结、转移性淋巴结与炎性淋巴结及良、恶性淋巴结的ADC值鉴别诊断阈值分别为1.085×10-3mm2/s、1.575×10-3mm2/s、1.655×10-3mm2/s和1.575×10-3mm2/s,敏感性和特异性分别为41.5%、80.9%,78.6%、64.5%,84.5%、57.1%和78.2%、64.5%。结论 WB MR DWI结合ADC值对初诊不明原因淋巴结肿大原因有一定鉴别诊断价值,但对淋巴瘤与转移性淋巴结的鉴别价值有限。
Objective To investigate the value of whole body MR diffusion weighted imaging (WB MR DWI) in the differential diagnosis of newly diagnosed unexplained lymph nodes. Methods Totally 78 cases of newly diagnosed lymphadenopathy confirmed by pathology or clinic, including 31 cases of lymphoma (lymphoma group), 30 cases of metastatic lymph node metastasis (metastatic lymph node group), 17 cases of inflammatory lymph node (inflammatory lymph node group) . All patients underwent WB MR DWI before treatment. The number of lymph node lesions was recorded and the apparent diffusion coefficient (ADC) value was recorded. The results of independent sample t-test and receiver operating characteristic (ROC) curve analysis of every two groups Lesions ADC value identification. Results The average ADC values of lymphoma group, metastatic lymph node group and inflammatory lymph node group were (1.197 ± 0.388) × 10-3mm2 / s, (1.343 ± 0.299) × 10-3mm2 / s and (1.677 ± 0.466) × 10 -3mm2 / s, the average ADC value of lymphoma and metastatic lymph node group were significantly lower than the inflammatory group, the average ADC value of the lymphoma group was also less than the metastatic lymph node group (P <0.01), the application of ROC curve derived differential lymphoma The differential diagnostic thresholds of metastatic lymph nodes, lymphoma and inflammatory lymph nodes, metastatic lymph nodes and inflammatory lymph nodes and benign and malignant lymph nodes were 1.085 × 10-3mm2 / s, 1.575 × 10-3mm2 / s and 1.655 × Sensitivity and specificity were 41.5%, 80.9%, 78.6%, 64.5%, 84.5%, 57.1%, 78.2%, 64.5%, respectively, in the range of 10-3mm2 / s and 1.575x10-3mm2 / s. Conclusion The combination of WB MR DWI and ADC value has some differential diagnostic value for newly diagnosed unexplained lymph node enlargement, but it has limited value in differentiating lymphoma from metastatic lymph node.