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The Clinical Investigation of Diagnosis and Treatment of Lymphoma with Whole Body Diffusion-weighted Imaging

Author: MengYun
Tutor: ChengJingLiang
School: Zhengzhou University
Course: Medical Imaging and Nuclear Medicine
Keywords: Magnetic resonance body diffusion-weighted imaging Lymphoma ADC values Lymph node
CLC: R733.1
Type: Master's thesis
Year: 2011
Downloads: 39
Quote: 1
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Abstract


Background and Purpose malignant lymphoma is a malignant cancer of the primary in the lymph nodes or extranodal lymphoid tissue, according to the difference of the pathological and clinical features can be divided into Hodgkin's lymphoma and non-Hodgkin's lymphoma version of \The lymphoid neoplasms WHO classification, a total of 80 lymphoma subtypes, including non-Hodgkin's lymphoma is divided into derived from B-cell non-Hodgkin's lymphoma and T / NK cell-derived non-Hodgkin's lymphoma. Hodgkin's lymphoma and non-Hodgkin's lymphoma are painless lymph nodes is a common first manifestation of systemic lymph nodes can be involved, and often accompanied by liver, spleen enlargement, late symptoms and signs of fever, anemia, and cachexia. The higher incidence of malignant lymphoma in Europe and the United States, China in recent years the number of patients is increasing year by year. For patients with malignant lymphoma, early diagnosis, accurate staging ground detection is the key to diagnosis and treatment. Malignant lymphoma imaging methods including X-ray computed tomography (X-ray computed tomography, CT), ultrasound, magnetic resonance imaging (magnetic resonance imaging, MRI), positron emission computed tomography (Positron Emission Computed tomography PET-CT) examination. CT is an important imaging methods diagnosis of lymphoma, lymph node morphology, size, internal organs infiltration observed high sensitivity; However, CT scans only for local, can not take into account the whole body at the same time CT scans ionizing radiation, multiple scans in the short-term damage on the human body. Ultrasound, low prices; lesions but it can only provide anatomical information, as the basis to determine the size of lymph nodes and lymphoid organs lymphoma patient's condition. PET-CT melting PET and CT (?) Body, the function of the lesion and Molecular Metabolism information provided by the PET scan, the specific anatomic location of the lesion by CT scan, a scan obtained tomographic image of the body, to achieve the early detection of lesions and diagnosis of disease. However, due to the presence of ionizing radiation and the high cost of PET-CT in extensive clinical application is still subject to certain constraints. With the continuous improvement of the magnetic resonance field strength and the corresponding post-processing software research and development, functional magnetic resonance imaging plays an increasingly important role in the diagnosis of neoplastic diseases. Body diffusion-weighted imaging (whole body diffusion weighted imaging, WB-DWI) is a functional magnetic resonance imaging, it will echo planar imaging (echo planar imaging, EPI), a short time inversion recovery imaging (short time inversion recovery STIR), the sensitive coding technique (sensitivity encoding, SENSE) integration, diffusion of water molecules by detecting the body to determine the extent of movement of the body cells of benign and malignant, benign and malignant disease at the molecular level diagnosis. Magnetic resonance WB-DWI technology to check radiation damage, without the need for contrast agents, patient acceptability, safety and feasibility of short-term follow-up. In recent years, the WB-DWI gradually become one of the hotspots of the imaging studies at home and abroad, and gradually used clinically. This paper aims to initially elaborated the magnetic resonance WB-DWI technology in the screening, diagnosis of malignant lymphoma, lymph nodes for the difference between benign and malignant qualitative and quantitative data. Materials and methods collected in attending the First Affiliated Hospital of Zhengzhou University, January 2010 to March 2011 and has been clinically diagnosed patients with malignant lymphoma in 45 cases, including 29 males and 16 females, aged 10 to 76 years, mean age 43.62 ± 3.2 years old; including Hodgkin's lymphoma cases, non-Hodgkin's lymphoma in 37 cases. 37 patients with non-Hodgkin's lymphoma patients, according to their different sources of cells, B cells derived 22 cases of non-Hodgkin's lymphoma, T-cell-derived non-Hodgkin's lymphoma in 15 cases. Selected 20 normal volunteers, male, female 10, age 21 to 73 years, mean age 45.31 ± 4.6 years old. All 45 patients and 20 normal volunteers were used the Netherlands Philips Intera Achieva 1.5T superconducting magnetic resonance scanner magnetic resonance body diffusion-weighted imaging scan. Philips EWS workstation after the end of the scan, the scan data processing, ADC value measurement lymph nodes. Body diffusion-weighted magnetic resonance imaging images combined with the same period in other imaging data and pathological result rows comparative analysis to compare the different nature of the lymph node ADC value difference. All measurement results are expressed as mean ± standard deviation (X ± S), compared using one-way ANOVA, two sample t-test was used to compare the data. All data were statistically analyzed using SPSS 17.0 statistical package, as a = 0.05 significance level. Body diffusion-weighted imaging performance results in normal volunteers showed low signal: background signal, such as muscle, fat, blood vessels signal is sufficiently suppressed. Central nervous system, parotid, submandibular gland, kidney, spleen, disc, ovarian, prostate significantly higher signal; submandibular, and oropharyngeal lymphatic ring, neck, collarbone, armpits, groin area a small punctate slightly higher visible symmetrical distribution signal developing lymph nodes. Normal volunteers lymph nodes mean ADC value (1198.70 ± 89.58) × 10-6mm2 / s, different genders, the difference between the ADC values ??of the different parts of the lymph nodes was not statistically significant (P gt; 0.05) 45 cases of malignant lymphoma patients showed bilateral submandibular, oropharyngeal lymphatic ring, neck, collarbone, armpits, groin area visible nodules of varying the size of the symmetrical distribution or mass slightly higher signal intensity lesions lymph nodes. Malignant lymphoma patients with lymph node mean ADC value (752.23 ± 60.66) × 10-6mm2 / s, the difference between the different parts of the ADC values ??of malignant lymph nodes was not statistically significant (P gt; 0.05) Hodgkin's lymphoma patients with lymph node mean ADC value (779.25 ± 71.28) × 10-6mm2 / s, non-Hodgkin's lymphoma patients with lymph node mean ADC value (746.39 ± 57.54) × 10-6mm2 / s, two between the difference was not statistically significant (t = 1.41, P = 0.167). B-cell-derived non-Hodgkin's lymphoma patients with lymph node mean ADC value (748.28 ± 38.10) × 10-6mm2 / s, T / NK cell-derived non-Hodgkin's lymphoma patients with lymph node mean ADC value (751.37 ± 39.84) × 10-6mm2 / s, the difference between the two groups was not statistically significant (t = -0.24, P = 0.814). Malignant lymphoma patients with lymph node treatment, the mean ADC value after the difference was statistically significant (P lt; 0.001). Normal volunteers lymph nodes, malignant lymphoma patients with lymph node between the mean ADC value difference was statistically significant (P lt; 0.001). Conclusion 1. WB-DWI is a reliable imaging method for malignant lymphoma lymph nodes and diagnosis of lymphoma effect. ADC value determination helps lymph node benign and malignant WB-DWI is difficult to identify and determine the subtype of the lymph nodes

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CLC: > Medicine, health > Oncology > Hematopoietic and lymphoid neoplasms > Reticuloendothelial system tumors
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