双指数模型IVIM-DWI成像技术在颈部淋巴结病变的鉴别诊断价值

The Value of Differentiatial Diagnosis for Lymph Node Diseases in Neck with Application of Bi-exponential Model Intravoxel Incoherent Motion Diffusion Weighted Imaging

目的:探讨双指数模型体素内不相干运动扩散加权成像(IVIM-DWI)技术在颈部淋巴结病变中的鉴别诊断价值。方法:搜集2018年2月至2019年12月颈部淋巴结肿大患者共48例,其中良性增生组12例、淋巴瘤组16例、鳞癌淋巴结转移组20例,对所有患者同时行常规MRI平扫及IVIM-DWI扫描,IVIM-DWI序列b值取值为:0,10,20,30,50,80,100,150,200,300,400,600,800,1000s/mm^2共14个,采用One-Way ANOVA法来比较不同组别间的参数值差异。结果:鳞癌淋巴结转移的D*值显著高于良性淋巴结增生(P=0.008),其D值及ADC值显著低于后者(P=0.013及0.031),它们之间的f值则无显著性的差异(P=0.265)。淋巴瘤的D值、ADC值和D*值均显著低于鳞癌淋巴结转移、良性淋巴结增生(P<0.05),它们之间的f值亦无显著性的差异(P>0.1)。结论:双指数模型体素内不相干运动扩散加权成像(IVIM-DWI)技术在颈部淋巴结病变鉴别诊断中具有较高的临床价值。

Objective:To explore the value differentiatial diagnosis for lymph node diseases in neck based on bi-exponential model intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI).Methods:From February 2018 to December 2019,48 consecutive patients with lymph node enlarged in neck were enrolled in this study.The subjects were 12 patients with lymph node hyperplasia and 16 patients with lymphoma,and 20 patients with lymph node of metastasis squamous cell carcinoma.All patients underwent a 3.0 T magnetic resonance(MR)examination.IVIM diffusion-weighted imaging was performed with 14 b values(0,10,20,30,50,80,100,150,200,300,400,600,800,1000 mm^2),One-Way ANOVA test was used to compare D,D*,f and ADC values between them.Results:In lymph node of metastasis squamous cell carcinoma group,the D*values were significantly higher(P=0.008)and D,ADC values lower than those in lymph node of hyperplasia(P=0.013及0.031).The D,D*and ADC values in lymphoma group were significantly lower than those both lymph node of metastasis squamous cell carcinoma and lymph node hyperplasia(P<0.05).The f values were not significantly different between any two groups of them(P>0.05).Conclusion:Bi-exponential model IVIM-DWI is a feasible way to differentiate lymph node diseases in neck.