颈部淋巴结转移和反应性增生的间质磁共振造影表现

中国口腔颌面外科杂志 ›› 2016, Vol. 14 ›› Issue (3): 218-222.

颈部淋巴结转移和反应性增生的间质磁共振造影表现

高倩倩¹, 冯元勇¹, 刘世恩², 万升标³, 江涛³, 尚伟¹

1.青岛大学附属医院口腔颌面外科;
2.放射科,山东青岛 266003; 3.中国海洋大学医药学院, 山东青岛 266003

收稿日期:2015-12-15 出版日期:2016-06-20 发布日期:2016-07-04
通讯作者: 尚伟,E-mail：liweishang@126.com

An experimental study of IMRLG enhanced by dextran-DTPA-Gd in detecting metastatic and reactively hyperplastic cervical lymph nodes

GAO Qian-qian¹, FENG Yuan-yong¹, LIU Shi-en², WAN Sheng-biao³, JIANG Tao³, SHANG Wei¹

1.Department of Oral and Maxillofacial Surgery, 2. Department of Radiology, the Affiliated Hospital of Qingdao University. Qingdao 266003; 3.Key Laboratory of Marine Drugs, Ministry of Education, School of Pharmacy, Ocean University of China. Qingdao 266003, Shandong Province, China)

Received:2015-12-15 Online:2016-06-20 Published:2016-07-04

摘要/Abstract

摘要： 目的探讨颈部淋巴结转移和反应性增生的dextran-DTPA-Gd间质磁共振造影特点。方法12只新西兰大白兔随机分为颈部淋巴结反应性增生及颈部淋巴结转移2组模型。建模成功后,行双侧舌缘黏膜下注射dextran-DTPA-Gd各0.2 mL,分别于注射后5、15、45、60 min,4、24 h行间质磁共振淋巴造影(interstitial magnetic resonance lymphography,IMRLG)检查,分析其淋巴显影强化程度,计算强化前、后的信号强度(E%),绘制信号强度-时间曲线,并对磁共振图像与病理结果进行比较分析。采用SPSS17.0软件包对数据进行统计学分析。结果肿瘤组45 min时的信号强度达到峰值（289%）,增生组30 min达到峰值（367%）,相同时间的信号强化率差异显著（P<0.05）。IMRLG肿瘤组诊断为转移阳性淋巴结24枚,其中,2枚经病理证实为假阳性,阳性诊断率为91.67%(22/24);增生组27枚淋巴结误诊为肿瘤转移5枚,假阳性率为18.5%(5/27)。结论Dextran-DTPA-Gd间质磁共振造影具有鉴别颈部淋巴结转移和反应性增生的应用价值。

关键词: 转移性淋巴结, 反应性增生淋巴结, 磁共振成像, 淋巴造影, 钆

Abstract: PURPOSE: To investigate the characteristics of metastatic and reactively hyperplastic lymph nodes in interstitial magnetic resonance lymphography enhanced by dextran-DTPA-Gd. METHODS: Twelve New Zealand white rabbits were divided into 2 groups at random：reactive hyperplasia group and tumor group. 0.2 mL dextran-DTPA-Gd was injected into the bilateral submucosa of the tongue in 12 New Zealand rabbits. Then the MR images by using 3-D enhancement magnetic resonance lymphography at 5, 15, 30, 45, 60 mins and 4, 24 h after injection were obtained. The signal intensities after enhancing were measured to calculate the enhanced rates (E%) of lymph nodes at the same time and the signal enhancing rates-time curve was drawn. The images were analyzed with pathological results.The data were analysed using SPSS17.0 software package. RESULTS: The signal of the tumor group reached a peak after 45 min with E% of 289% and the signal of reactive hyperplasia group reached a peak after 30 min with E% of 367%. The difference of enhancing rates between the metastatic lymph nodes and reactively hyperplastic lymph nodes was significant at the same time (P<0.05). In tumor group, 24 lymph nodes were diagnosed as metastatic lymph nodes by IMRLG with 2 false positivity; while 91.67% (22/24) metastatic lymph nodes were confirmed by pathological diagnosis. In the reactive hyperplasia group,5 lymph nodes were misdiagnosed as metastatic lymph nodes by IMRLG and the false-positive rate was 18.5% (5/27). CONCLUSIONS: IMRLG enhanced by dextran-DTPA-Gd could effectively detect metastatic and reactively hyperplastic cervical lymph nodes.

Key words: Metastatic lymph nodes, Reactively hyperplastic lymph nodes, Magnetic resonance imaging, Lymphography, Gadolinium

中图分类号:

R782

高倩倩, 冯元勇, 刘世恩, 万升标, 江涛, 尚伟. 颈部淋巴结转移和反应性增生的间质磁共振造影表现[J]. 中国口腔颌面外科杂志, 2016, 14(3): 218-222.

GAO Qian-qian, FENG Yuan-yong, LIU Shi-en, WAN Sheng-biao, JIANG Tao, SHANG Wei. An experimental study of IMRLG enhanced by dextran-DTPA-Gd in detecting metastatic and reactively hyperplastic cervical lymph nodes[J]. China J Oral Maxillofac Surg, 2016, 14(3): 218-222.

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