不同影像学方法在淋巴瘤分期诊断中的应用
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摘要
目的探讨磁共振(MRI)背景抑制弥散加权成像(DWIBS)和正电子发射断层显像/X线计算机体层成像仪(PET/CT)在淋巴瘤分期诊断中的应用。方法回顾性分析2017年2月-2018年2月我院收治的50例淋巴瘤患者的临床资料。所有患者均经病理活检确诊,并分别进行DWIBS和18氟-氟代脱氧葡萄糖(18F-FDG)PET/CT检查,比较两种方法对病灶的检查情况。根据淋巴瘤AnnArbor分期标准,分别作出两种影像学方法的淋巴瘤分期诊断,观察各自与临床分期的符合情况。结果 DWIBS和PET/CT检出病灶的总体差异和结内病灶检出差异均具有统计学意义(P<0.05),但两种方法检查结果具有较强的一致性(к=0.842、0.875);结外病灶检出情况,两种方法检查结果差异无统计学意义(P>0.05),但具有中等程度的吻合度(к=0.671)。DWIBS、PET/CT分期与临床分期符合率分别为80.00%(40/50)、92.00%(46/50),差异无统计学意义(P>0.05)。结论 DWIBS和PET/CT对淋巴瘤病灶检出有较高的一致性,对于分期诊断均有较高的准确性,且两者差异性不大。
Objective To explore the application of magnetic resonance imaging(MRI diffusion-weighted imaging with background suppression(DWIBS) and positron emission tomography/X-ray computed tomography(PET/CT) in the staging diagnosis of lymphoma. Methods The clinical data of 50 patients with lymphoma admitted to our hospital from February 2017 to February 2018 were retrospectively analyzed. All patients were diagnosed by pathological biopsy, and they were given DWIBS and 18 fluoro-fluorodeoxyglucose(18 F-FDG) PET/CT respectively. The lesions detection was compared by two methods. According to the Ann Arbor staging criteria of lymphoma,the lymphoma staging diagnosis was made by the two imaging methods, and their coincidence with clinical stages was observed. Results There were significant differences between DWIBS and PET/CT in total detected lesions and detection of intranodal lesions(P<0.05), but the results of the two methods were strongly consistent(к=0.842, 0.875).There was no significant difference in the detection of extranodal lesions between the two methods(P>0.05), but they were moderatelyconsistent(k=0.671). The coincidence rates of DWIBS and PET/CT staging with clinical stage were 80.00%(40/50) and 92.00%(46/50) respectively(P>0.05). Conclusion DWIBS and PET/CT have highconsistency in the lesionsdetection of lymphoma, and have high accuracy for staging diagnosis, and the difference between the two is not significant.
Objective To explore the application of magnetic resonance imaging(MRI diffusion-weighted imaging with background suppression(DWIBS) and positron emission tomography/X-ray computed tomography(PET/CT) in the staging diagnosis of lymphoma. Methods The clinical data of 50 patients with lymphoma admitted to our hospital from February 2017 to February 2018 were retrospectively analyzed. All patients were diagnosed by pathological biopsy, and they were given DWIBS and 18 fluoro-fluorodeoxyglucose(18 F-FDG) PET/CT respectively. The lesions detection was compared by two methods. According to the Ann Arbor staging criteria of lymphoma,the lymphoma staging diagnosis was made by the two imaging methods, and their coincidence with clinical stages was observed. Results There were significant differences between DWIBS and PET/CT in total detected lesions and detection of intranodal lesions(P<0.05), but the results of the two methods were strongly consistent(к=0.842, 0.875).There was no significant difference in the detection of extranodal lesions between the two methods(P>0.05), but they were moderatelyconsistent(k=0.671). The coincidence rates of DWIBS and PET/CT staging with clinical stage were 80.00%(40/50) and 92.00%(46/50) respectively(P>0.05). Conclusion DWIBS and PET/CT have highconsistency in the lesionsdetection of lymphoma, and have high accuracy for staging diagnosis, and the difference between the two is not significant.
引文
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[8]沈俊杰,张俊祥,陈守康,等.3. 0 T MRI类PET功能成像与PET/CT在淋巴瘤分期诊断中的对比研究[J].临床放射学杂志,2017, 36(5):733-738.
[9]付修威,陈元园,倪红艳,等.基于不同模型的多种新型MR扩散成像的原理与临床应用[J].中华放射学杂志,2017, 51(11):883-886.
[2]宫清,朱萍.1. 5T MR多b值扩散加权成像对乳腺病变的显示及对背景的抑制能力[J].河北医科大学学报,2017, 38(1 1):1 333-1 336.
[3]袁媛,李金娇,肖荦,等.Ann Arbor分期划分淋巴瘤淋巴结区域的意义探讨[J].中国现代医学杂志,2017, 27(10):107-111.
[4]陈炎,袁志平.骨髓活检术及FDGPET/CT在淋巴瘤骨髓侵犯诊断中的临床应用[J].肿瘤学杂志,2017, 23(5):433-437.
[5]邓禹,李爱玲,邱琳,等. P E T/MRI与PET/CT对淋巴瘤诊断一致性的系统评价[J].重庆医学,2017,46(19):2668-2671.
[6]朱源义,印隆林,童伦兵,等.肾上腺淋巴瘤CT及18F-FDG PET/C T主要特征分析[J].武警医学,2018, 29(5):468-472.
[7]岳建兰,尹亮,黄世明,等.鼻型结外NK/T细胞淋巴瘤的18F-FDG PET/CT表现及分期[J].中国医学影像学杂志,2017, 25(7):487-490.
[8]沈俊杰,张俊祥,陈守康,等.3. 0 T MRI类PET功能成像与PET/CT在淋巴瘤分期诊断中的对比研究[J].临床放射学杂志,2017, 36(5):733-738.
[9]付修威,陈元园,倪红艳,等.基于不同模型的多种新型MR扩散成像的原理与临床应用[J].中华放射学杂志,2017, 51(11):883-886.