CAJ | 학술논문

目的探讨扩散加权成像(DWI)鉴别腋窝炎性增生性与转移性淋巴结的价值.方法 40只健康雌性新西兰大白兔随机平均分成2组,分别建立腋窝炎性增生性和转移性淋巴结模型,建模成功后行常规MRI及DWI检查.观察两组淋巴结在MRI上的信号强度并于T2WI上测量其数值,于T2WI、DWI和ADC图上分别测量并比较两组淋巴结与同层面背侧肌肉的相对信号强度(rSIT2WI、rSIDWI)和相对表观扩散系数(rADC)值；应用受试者工作特性曲线(ROC)分析rADC值对良恶性淋巴结的鉴别诊断效能；以病理学为基础,分析两组淋巴结的rADC值与细胞密度的相关性.结果两组淋巴结的大小、rSIT2WI、rSIDWI差异均无统计学意义.炎性淋巴结的rADC值高于转移性淋巴结,分别为0.91 ±0.14、0.64±0.18,两者间差异有统计学意义(t=3.879,P=0.03),但仍存在小部分重叠.当rADC值取最佳阈值0.780时,其诊断的敏感性和特异性分别为86.2％和74.4％.两组淋巴结的rADC值与细胞密度呈负相关(r=-0.53,P=0.003).结论 rADC值相对于常规MRI序列能更准确地鉴别淋巴结的良恶性,细胞密度可能是影响两组淋巴结rADC值差异的关键因素.
목적 탐토확산가권성상(DWI)감별액와염성증생성여전이성림파결적개치.방법 40지건강자성신서란대백토수궤평균분성2조,분별건립액와염성증생성화전이성림파결모형,건모성공후행상규MRI급DWI검사.관찰량조림파결재MRI상적신호강도병우T2WI상측량기수치,우T2WI、DWI화ADC도상분별측량병비교량조림파결여동층면배측기육적상대신호강도(rSIT2WI、rSIDWI)화상대표관확산계수(rADC)치；응용수시자공작특성곡선(ROC)분석rADC치대량악성림파결적감별진단효능；이병이학위기출,분석량조림파결적rADC치여세포밀도적상관성.결과 량조림파결적대소、rSIT2WI、rSIDWI차이균무통계학의의.염성림파결적rADC치고우전이성림파결,분별위0.91 ±0.14、0.64±0.18,량자간차이유통계학의의(t=3.879,P=0.03),단잉존재소부분중첩.당rADC치취최가역치0.780시,기진단적민감성화특이성분별위86.2％화74.4％.량조림파결적rADC치여세포밀도정부상관(r=-0.53,P=0.003).결론 rADC치상대우상규MRI서렬능경준학지감별림파결적량악성,세포밀도가능시영향량조림파결rADC치차이적관건인소.
Objective To evaluate the value of diffusion-weighted imaging (DWI) in the differentiation of axillary inflammatory hyperplastic and metastatic lymph nodes. Methods Forty female New Zealand white rabbits were divided randomly into 2 groups (n =20 each).And the animal models of axillary inflammatory hyperplastic and metastatic lymph nodes were established.All successfully implanted models received conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) examinations.The features of signal intensity and shapes of lymph nodes were observed in two groups.The sizes of lymph nodes were measured on the selected axial T2WI. The signal intensity and appearance diffusion coefficient (ADC) value of lymph nodes and dorsal muscle at the same slice were measured on the selected T2WI,DWI and ADC map respectively.The relative signal intensity (rSIT2WI,rSIDWI ) and relative ADC (rADC) value of lymph nodes to dorsal muscle were calculated and compared.The diagnostic efficacy of differentiating benign and malignant lymph nodes was analyzed with rADC value through the receiver operating characteristic curve. The correlation between rADC value and cell density was assessed with pathological findings as reference standard.Results The differences of size,rSIT2WI and rSIDWI were not statistically significant between two groups.The rADC value of inflammatory lymph nodes was greater than that of metastatic lymph nodes (0.91 ± 0.14 vs 0.64 ± 0.18 ).Significant difference existed ( t =3.879,P =0.03 ).But there was a little overlap between two groups.With 0.78 as the diagnostic threshold of rADC value,the sensibility and specificity was 86.2％ and 74.4％ respectively.The correlation between rADC value and cell density of inflammatory hyperplastic and metastatic lymph nodes was significantly inverse (r =- 0.53,P =0.003 ).Conclusion As compared with the routine MRI sequence,rADC value has a higher diagnostic efficacy in the differentiation of benign and malignant lymph nodes.Cell density may be the most important influencing factor for the differences of rADC value between two groups of lymph nodes.