MR-DWI在前纵隔淋巴瘤诊断中的应用

Application of MR-DWI in the Diagnosis of Anterior Mediastinal Lymphoma

目的 探讨磁共振弥散加权成像(MR-DWI)在前纵隔淋巴瘤诊断中的应用价值。方法 将本院2016年6月至2019年12月收治的临床病理检查确诊为前纵隔淋巴瘤患者设为淋巴瘤组(n=78),确诊为非淋巴瘤良性病变患者设为非淋巴瘤组(n=75)。两组患者均进行磁共振(MRI)和MR-DWI检查,观察比较两组经MR-DWI检查测出的表观扩散系数(ADC);ROC曲线分析MR-DWI检查得出的ADC对前纵隔淋巴瘤的诊断价值。结果 淋巴瘤组ADC值为(0.76±0.16)×10^(-3)mm^(2)/s,低于非淋巴瘤组的(1.37±0.39)×10^(-3)mm^(2)/s(P<0.05);ROC曲线分析结果显示,ADC诊断前纵隔淋巴瘤的AUC为0.877,临界值为1.05×10^(-3)mm^(2)/s。MR-DWI检查诊断前纵隔淋巴瘤的敏感度(96.2%)、特异性(97.3%)、准确值(96.7%)、阳性预测值(97.4%)、阴性预测值(96.1%)、kappa值(0.935)均高于MRI检查(83.3%、84.0%、83.7%、84.4%、82.9%、0.673)(P<0.05)。结论 MR-DWI在前纵隔淋巴瘤诊断中具有较大的应用价值,能提高其诊断效能。

Objective To investigate the value of magnetin resonance diffusion-weighted imaging(MR-DWI) in the diagnosis of anterior mediastinal lymphoma. Methods The patients with anterior mediastinal lymphoma diagnosed by clinical pathology from June 2016 to December 2019 in our hospital were set as lymphoma group(n=78),and the patients with non lymphoma benign lesions were set as non lymphoma group(n=75). Magnetic resonance imaging(MRI) and MR-DWI were performed in both groups. The apparent diffusion coefficient(ADC) measured by MR-DWI was observed and compared between the lymphoma group and non lymphoma group;ROC curve was used to analyze the diagnostic value of ADC obtained from MR-DWI in anterior mediastinal lymphoma. Results ADC value of lymphoma group was(0.76±0.16)×10^(-3)mm^(2)/s,which was lower than that of non lymphoma group(1.37±0.39)×10^(-3)mm^(2)/s(P<0.05);ROC curve analysis results showed that AUC of ADC in diagnosing anterior mediastinal lymphoma was 0.877,and the critical value was 1.05×10^(-3)mm^(2)/s. The sensitivity(96.2%),specificity(97.3%),accuracy(96.7%),positive predictive value(97.4%),negative predictive value(96.1%),kappa value(0.935) of MR-DWI in the diagnosis of anterior mediastinal lymphoma were higher than those of MRI(83.3%,84.0%,83.7%,84.4%,82.9%,0.673)(P<0.05). Conclusion MR-DWI is of great value in the diagnosis of anterior mediastinal lymphoma and can improve its diagnostic efficacy.