简体中文

论著-头颈部

不同影像学方法在 淋巴瘤分期诊断中 的应用

作者:王根杰 田 颖

所属单位:河南省商丘市第一人民医院血液内 科 (河南 商丘 476100)

PDF

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 Ann Arbor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 (18F-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.

【关键词】淋巴瘤;分期诊断;DWIBS; PET/CT

【中图分类号】R733.4;R445.2;R445.5

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2019.04.046

前言

淋巴瘤是一种起源于免疫系统细胞及其前体细胞的恶性肿瘤,属 于淋巴网状系统恶性增生性疾病,在我国该疾病发病率有逐年上升的 趋势。大多淋巴瘤患者为全身多部位发病,局部检查往往漏诊、误 诊,耽误疾病治疗,于病情转归不利。因此,临床上对该疾病的诊 断,不仅需要针对某个器官进行CT或MRI检查,还需对全身进行正电子 发射断层显像/X线计算机体层成像仪(PET/CT)检查,以全面了解病情 进展[1]。但PET/CT价格昂贵、缺乏特异性,且具有放射危害性,不适合 多次检查和随访。随着影像学技术的发展,磁共振(MRI)背景抑制弥散 加权成像(DWIBS)也可对患者进行全身扫描,且具有价格低廉、无辐射 损伤、可反复检查等优势[2]。本研究旨在探讨DWIBS和PET/CT在淋巴瘤 分期诊断中的应用,现报道如下。