DWI对颈部淋巴结病变良恶性的鉴别诊断价值

The value of diffusion weighted imaging in the differential diagnosis between benign and malignant cervical lymph node lesions

目的:探讨DWI及其定量参数ADC值对颈部淋巴结病变良恶性的鉴别诊断价值。方法:回顾性分析经病理证实的颈部淋巴结病变患者49例共116个病灶,分为恶性组28例(60个病灶)和良性组21例(56个病灶)。患者均行常规MRI及DWI检查,测量并比较2组的ADC值,以病理结果为金标准,绘制ROC曲线,观察ADC值的诊断效能。结果:恶性组淋巴结平均ADC值为(0.73±0.17)×10^(-3)mm^2/s,低于良性组的(1.02±0.23)×10^(-3)mm^2/s(P<0.05)。经ROC曲线分析,ADC阈值为0.82×10^(-3)mm^2/s时,区分颈部淋巴结良恶性病变的诊断灵敏度、特异度和曲线下面积分别为78.6%、73.3%和0.843。结论:ADC值对颈部良恶性淋巴结病变具有鉴别诊断价值。

Objective：To investigate the utility value of DWI in the differential diagnosis between benign and malignant cervical lymph node lesions. Methods：49 patients with pathologically confirmed cervical lymph node lesions were analyzed retrospectively and categorized into benign and malignant groups. Malignant group included 28 patients with 60 lesions,while 21 patients in benign group had 56 lesions. All patients underwent conventional MR and DWI （to obtain ADC）. The ADC mean values of benign and malignant group were measured and analyzed. Diagnostic efficacy of ADC was evaluated by using Receiver operating characteristic curve,with pathological findings as the gold standard. Results：ADC of malignant group were lower than the benign group [ADC：（0.73 ± 0.17）×10^-3 mm2/s vs（1.02± 0.23）×10^-3 mm2/s]. Significant inter-group difference was observed in ADC （P〈0.05）. By ROC curve analysis,using a threshold ADC value of 0.82×10^-3 mm2/s for differentiating malignant cervical lymph nodes from benign lymph nodes,a sensitivity of 78.6% and specificity of 73.3% were obtained,the area under the ROC curve was 0.843. Conclusion：The ADC value is helpful for the differential diagnosis between benign and malignant cervical lymph node lesions.