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目的:研究弥散加权成像(DWI)对鼻咽癌(NPC)原发灶及其转移性淋巴结的诊断价值。方法:选取我院2013年12月至2014年12月收治的鼻咽癌患者42例为观察组,另选30例健康体检者,两组均接受常规核磁共振(MR)检测及DWI检测,分析两种检测方式结果及鼻咽癌原发灶、转移淋巴结及正常淋巴结表现弥散系数(ADC)值差异。结果:观察组肿块型35例、黏膜型7例,轴位黏膜最厚为1.3cm且图像清晰度差于肿块型。观察组转移淋巴结共75枚,包括颈部淋巴结64枚、咽旁淋巴结11枚。转移增大淋巴结DWI全部检出,检出率为100%,常规MR检出38例,占90.48%,DWI检出率偏高但两组比较无统计学意义(χ2=0.718,P>0.05),对照组30例共检出39枚淋巴结,均正常;鼻咽癌原发灶ADC值为(0.764±0.142),转移淋巴结为(0.846±0.134),正常淋巴结为(1.067±0.183),原发灶ADC与转移淋巴结比较,差异无统计学意义(P>0.05),而前两者与正常淋巴结比较,差异具有统计学意义(P<0.05)。结论:DWI可准确鉴别鼻咽癌原发灶及转移性淋巴结,诊断价值优于常规MR检测。
Objective: To investigate the diagnostic value of diffusion-weighted imaging (DWI) in primary lesions of nasopharyngeal carcinoma (NPC) and metastatic lymph nodes. Methods: Forty-two patients with nasopharyngeal carcinoma who were treated in our hospital from December 2013 to December 2014 were selected as the observation group and 30 healthy subjects were selected. Both groups were examined by routine MR and DWI The results of the two methods and nasopharyngeal carcinoma primary metastasis, lymph node metastasis and normal lymph node performance diffusion coefficient (ADC) values. Results: In the observation group, there were 35 cases with mass type and 7 cases with mucosal type. The axial thickness of the mucosa was 1.3 cm and the image resolution was worse than that of the lump type. The observation group had a total of 75 lymph node metastases, including 64 cervical lymph nodes and 11 parapharyngeal lymph nodes. The detection rate of DWI was 100%, and 38 cases were detected by conventional MR, accounting for 90.48%. The detection rate of DWI was high but there was no significant difference between the two groups (χ2 = 0.718, P> 0.05) . The control group had a total of 39 lymph nodes in all 30 cases. The ADC value of the primary tumor in nasopharyngeal carcinoma was (0.764 ± 0.142), (0.846 ± 0.134) and normal lymph nodes (1.067 ± 0.183, There was no significant difference in ADC between ADC and lymph node metastasis (P> 0.05), while the difference between ADC and normal lymph nodes was statistically significant (P <0.05). Conclusion: DWI can accurately identify the primary tumor and metastatic lymph nodes of nasopharyngeal carcinoma, the diagnostic value is superior to the conventional MR detection.