中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2012年
5期
449-452
,共4页
李玉来%刘宁飞%许建荣%路青
李玉來%劉寧飛%許建榮%路青
리옥래%류저비%허건영%로청
淋巴水肿%磁共振成像%淋巴造影术
淋巴水腫%磁共振成像%淋巴造影術
림파수종%자공진성상%림파조영술
Lymphedema%Magnetic resonance imaging%Lymphography
目的 评估MR重T2WI和间质MR淋巴管成像(MRL)联合应用显示下肢淋巴水肿患者形态改变的价值.方法 回顾性分析31例原发性淋巴水肿患者40条病变下肢资料,患者行MR重T2WI和间质MRL,对淋巴管成像图像进行分析.重T2WI和间质MRL图像上显示淋巴管数目及淋巴液积聚的比较采用秩和检验,信噪比(SNR)和对比噪声比(CNR)及扩张淋巴管最大径的比较采用配对t检验.结果 在重T2WI上共显示498条扩张淋巴管,每条肢体显示扩张淋巴管的中位数为5(1～24)条；在MRL上共显示356条淋巴管,每条肢体显示扩张淋巴管的中位数为3(1～16)条,重T2WI显示扩张淋巴管的数目多于MRL,差异有统计学意义(Z=-2.92,P＜0.01).在显示最大径方面,重T2WI上扩张淋巴管的最大径为(4.3±1.5)mm,间质MRL上为(3.4±1.0)mm,差异有统计学意义(t=6.90,P＜0.01)；在显示扩张淋巴管的SNR和CNR方面,间质MRL(分别为257±130和207±113)均优于重T2WI(分别为169±91和135±82),差异均有统计学意义(t值分别为-5.95和-5.10,P值均＜0.01).在显示淋巴液积聚方面,重T2WI(中位数为1个)优于间质MRL(中位数为0个),差异有统计学意义(Z=-5.64,P＜0.01).结论 重T2WI具有较高的敏感度,而MRL具有较高的SNR和CNR,结合两者能更好地显示出下肢淋巴水肿患者的淋巴管结构.
目的 評估MR重T2WI和間質MR淋巴管成像(MRL)聯閤應用顯示下肢淋巴水腫患者形態改變的價值.方法 迴顧性分析31例原髮性淋巴水腫患者40條病變下肢資料,患者行MR重T2WI和間質MRL,對淋巴管成像圖像進行分析.重T2WI和間質MRL圖像上顯示淋巴管數目及淋巴液積聚的比較採用秩和檢驗,信譟比(SNR)和對比譟聲比(CNR)及擴張淋巴管最大徑的比較採用配對t檢驗.結果 在重T2WI上共顯示498條擴張淋巴管,每條肢體顯示擴張淋巴管的中位數為5(1～24)條；在MRL上共顯示356條淋巴管,每條肢體顯示擴張淋巴管的中位數為3(1～16)條,重T2WI顯示擴張淋巴管的數目多于MRL,差異有統計學意義(Z=-2.92,P＜0.01).在顯示最大徑方麵,重T2WI上擴張淋巴管的最大徑為(4.3±1.5)mm,間質MRL上為(3.4±1.0)mm,差異有統計學意義(t=6.90,P＜0.01)；在顯示擴張淋巴管的SNR和CNR方麵,間質MRL(分彆為257±130和207±113)均優于重T2WI(分彆為169±91和135±82),差異均有統計學意義(t值分彆為-5.95和-5.10,P值均＜0.01).在顯示淋巴液積聚方麵,重T2WI(中位數為1箇)優于間質MRL(中位數為0箇),差異有統計學意義(Z=-5.64,P＜0.01).結論 重T2WI具有較高的敏感度,而MRL具有較高的SNR和CNR,結閤兩者能更好地顯示齣下肢淋巴水腫患者的淋巴管結構.
목적 평고MR중T2WI화간질MR림파관성상(MRL)연합응용현시하지림파수종환자형태개변적개치.방법 회고성분석31례원발성림파수종환자40조병변하지자료,환자행MR중T2WI화간질MRL,대림파관성상도상진행분석.중T2WI화간질MRL도상상현시림파관수목급림파액적취적비교채용질화검험,신조비(SNR)화대비조성비(CNR)급확장림파관최대경적비교채용배대t검험.결과 재중T2WI상공현시498조확장림파관,매조지체현시확장림파관적중위수위5(1～24)조；재MRL상공현시356조림파관,매조지체현시확장림파관적중위수위3(1～16)조,중T2WI현시확장림파관적수목다우MRL,차이유통계학의의(Z=-2.92,P＜0.01).재현시최대경방면,중T2WI상확장림파관적최대경위(4.3±1.5)mm,간질MRL상위(3.4±1.0)mm,차이유통계학의의(t=6.90,P＜0.01)；재현시확장림파관적SNR화CNR방면,간질MRL(분별위257±130화207±113)균우우중T2WI(분별위169±91화135±82),차이균유통계학의의(t치분별위-5.95화-5.10,P치균＜0.01).재현시림파액적취방면,중T2WI(중위수위1개)우우간질MRL(중위수위0개),차이유통계학의의(Z=-5.64,P＜0.01).결론 중T2WI구유교고적민감도,이MRL구유교고적SNR화CNR,결합량자능경호지현시출하지림파수종환자적림파관결구.
Objective To access the value of combined application of high-resolution interstitial MR lymphangiography (MRL) and heavily T2WI for the visualization of lymphatic vessels in patients with primary lymphedema.Methods Forty lower extremities in 31 patients with primary lymphedema were examined by heavily T2 WI and interstitial MRL with a 3.0 T MR unit (Philips Medical Systems,Best,the Netherlands).Two experienced radiologists analyzed the images and tried to determine the differences in number of lymphatic vessels,and their maximum diameters,SNR and CNR,and accumulated lymph fluid in the tissue.Statistical analyses were conducted by using Wilcoxon test and t test.Results Dilated lymphatic vessels in 73 leg segments of 40 lower extremities were visualized on heavily T2WI (median 5,1 to 24),which were more than those on MRL ( median 3,1 to 16) (Z =-2.92,P ＜ 0.01 ).The maximum diameter of lymphatic vessels was (4.3 ± 1.5 ) mm on heavily T2 WI,whereas it was ( 3.4 ± 1.0) mm on MRL ( t =6.90,P ＜ 0.0 1 ).The average SNR and CNR in the dilated lymphatic vessels were 257 ± 130,207 ± 113 on MRL and 169 ± 91,135 ± 82 on heavily T2 WI,which was statistically significant ( SNR t =- 5.95,CNR t =-5.10; P ＜ 0.01 ).The visualization of regions of accumulated lymph fluid on heavily T2WI (median 1 ) had a higher score than that on MRL ( median 0 ) ( Z =- 5.64,P ＜ 0.01 ).Conclusions The heavily T2WI has greater sensitivity and the MRL image has better SNR and CNR.Combining these two MR techniques can provide adequate information for clinicians in the therapeutic planning of patients with advanced stages of lymphedema.
