磁共振弥散加权成像联合灌注成像定性诊断颈部淋巴结的价值

Value of magnetic resonance imaging diffusion weighted imaging combined with perfusion-weighted imaging in qualitative diagnosis of cervical lymph nodes

目的探讨磁共振弥散加权成像(MRI-DWI)联合灌注成像(PWI)定性诊断颈部淋巴结的价值。方法选取2017年2月至2018年3月于福建医科大学附属漳州市医院就诊的120例单侧或双侧颈部淋巴结肿大患者作为研究对象,所有患者均行MRI-DWI、PWI检查,以穿刺活检病理结果为金标准,分析MRI-DWI联合PWI定性诊断颈部淋巴的效能。结果120例患者,经穿刺活检病理检查,确诊恶性颈部淋巴结35例,良性颈部淋巴结85例;MRI-DWI联合PWI定性诊断颈部淋巴结的准确度为92.50%、灵敏度为88.57%、特异度为94.12%、阳性预测值为86.11%、阴性预测值为95.24%;经一致性Kappa度量,MRI-DWI联合PWI定性诊断颈部淋巴结与穿刺活检病理结果的一致性较好(Kappa=0.820,P=0.000);恶性颈部淋巴结患者的表观弥散系数(ADC)值小于良性颈部淋巴结患者,差异有统计学意义(P<0.05)。结论MRI-DWI联合PWI定性诊断颈部淋巴结与穿刺活检病理结果的一致性较好,诊断效能较高。

Objective To explore the value of MRI-DWI combined with PWI in qualitative diagnosis of cervical lymph nodes.Methods From February 2017 to March 2018,120 patients with unilateral or bilateral cervical lymphadenopathy in Zhangzhou Hospital Affiliated to Fujian Medical University were selected as the research objects.All patients were examined by MRI-DWI and PWI,and the diagnostic efficiency of MRI-DWI combined with PWI in qualitative diagnosis of cervical lymphadenopathy was analyzed based on the pathological results of puncture biopsy.Results Among 120 patients,35 cases were diagnosed as malignant and 85 cases as benign by biopsy;The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of MRI-DWI combined with PWI were 92.50%,88.57%,94.12%,86.11%and 95.24%,respectively;According to kappa measurement,the qualitative diagnosis of cervical lymph nodes by MRI-DWI combined with PWI was consistent with the pathological results of biopsy(Kappa=0.820,P=0.000);The ADC of patients with malignant cervical lymph nodes was lower than that of patients with benign cervical lymph nodes,and the difference was statistically significant(P<0.05).Conclusion MRI-DWI combined with PWI in qualitative diagnosis of cervical lymph nodes has good consistency with the pathological results of puncture biopsy,and has high diagnostic efficiency.