表观弥散系数在颈部结核性肿大淋巴结诊疗中的临床应用价值
Clinical value of apparent diffusion coefficient in diagnosis and treatment of cervical tuberculous enlarged lymph nodes
朱佩玉 1杨月1
作者信息
- 1. 上海大学附属南通医院放射科,江苏南通 226000
- 折叠
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 TMRI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)× 10-3mm2/s,炎症性肿大淋巴结组平均ADC值为(1.27± 0.39)× 10-3 mm2/s,肿瘤性肿大淋巴结组平均ADC值为(0.87±0.26)× 10-3 mm2/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 mm2/s,治疗后平均ADC值为(0.99±0.08)× 10-3 mm2/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)× 10-3mm2/s,治疗后平均 ADC 值(0.91±0.13)× 10-3 mm2/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 mm2/s,治疗后平均ADC值为(1.13±0.22)× 10-3 mm2/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.
Abstract
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 tubercu-lous 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 val-ues 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.Re-sults The average ADC value of tuberculous enlarged lymph node group was(1.09±0.29)×10-3 mm2/s,inflammatory enlarged lymph node group was(1.27±0.39)×10-3 mm2/s,neoplastic enlarged lymph node group was(0.87±0.26)×10-3 mm2/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 mm2/s,which was statis-tically significantly lower than before treatment[(1.14±0.23)×10-3 mm2/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 mm2/s vs(0.91±0.13)×10-3 mm2/s.P＞0.05].In lymph node enlargement group,the average ADC value before and after treatment were(1.12±0.10)×10-3 mm2/s and(1.13±0.22)×10-3 mm2/s,respectively,and there was no statistically significant difference between 2 groups(P＞0.05).Conclu-sion It is demonstrated that ADC value could help to differentiate and diagnose cervical tuberculous enlarged lymph nodes,in-flammatory enlarged lymph nodes and neoplastic enlarged lymph nodes,which could also evaluate the anti-tuberculosis treatment effect of cervical lymph tuberculosis and provide reference for clinical diagnosis and treatment.
关键词
颈部淋巴结/淋巴结核/MRI/表观弥散系数(ADC)Key words
cervical lymph node/enlarged lymph nodes/MRI/apparent diffusion coefficient(ADC)引用本文复制引用
基金项目
南通市科技局指导性项目(JCZ20186)
南通市科技局级青年A课题(QA2021049)
出版年
2024
NETL
NSTL
万方数据