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Experimental Study on the Differential Diagnosis of Metastatic and Inflammatory Hyperplasia Lymphnodes with the Use of SPIO-Enhanced MRI

Author: WangShengYu
Tutor: LiuShiYuan；WangChenGuang
School: Second Military Medical University
Course: Medical Imaging and Nuclear Medicine
Keywords: Superparamagnetic iron oxide particles Lymph node Magnetic resonance imaging Popliteal Gadolinium - diethylenetriamine pentaacetic acid
CLC: R445.2
Type: Master's thesis
Year: 2010
Downloads: 45
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Abstract


The purpose of the first part of SPIO-enhanced MR I rabbit popliteal lymph node developing optimal injection Ways animal studies explore SPIO-enhanced MRI the best injection route Materials and Methods rabbit popliteal lymph node check equipment and reagents: ① GE SIGNA EXCITE 1.5T MRI scanner. ② rabbit scan dedicated coils. ③ eggs, saline. ④ 3% sodium pentobarbital. ⑤ superparamagnetic iron oxide particles (SPIO). ⑥ New Zealand white rabbits 12, male and female, regardless of weight 2-2.5kg. The main experimental steps: (1) establishment of rabbit popliteal fossa lymph node reactive hyperplasia model: 12 New Zealand white rabbits hind thigh muscle injection the egg yolks solution (1:1), 3 days after repeated injections, one week modeling success. (2) the principle of randomization, 12 New Zealand white rabbits were divided into two groups. (3) an MRI scan. Scanning sequence T1WI, T2WI, GRE T2 * WI. Prior to the injection of SPIO MRI scan. The unenhanced After the first group by ear vein injection 10μmolFe second group by the hind toe web intradermal injection 10μmolFe. 12 hours after the end of the injection of an MRI scan. (4) scan after take popliteal fossa lymph node biopsy specimens for pathological examination, including HE staining and Prussian blue staining. (5) analysis of video images and pathology images. Statistical analysis was performed, including T1WI image measurement popliteal fossa lymph node size, measuring the signal strength of the two sets of popliteal lymph node enhanced before and after the scan sequence, and calculate the signal-to-noise ratio. Results The two groups of lymph node size (x ± s) were (9.81 ± 0.62) mm, (9.84 ± 0.70) mm. The two-sample t-test results showed no difference in the first group and the second group of lymph node size (p = 0.936, gt; 0.05). Plain, two groups of lymph nodes signals do not differ significantly. Muscle signals as a reference the T1 WI sequence of lymph nodes showed low signal or slightly higher signal; T2WI sequence lymph nodes showed signal or high signal: GRE T2 * WI sequence lymph nodes showed signal or high signal. Enhanced scan, the first group of popliteal lymph node in each sequence measured SNR with plain compared to each sequence, P values ??were gt; 0.05 (paired t-test); popliteal lymph node in each sequence measured the SNR plain sequence compared, respectively, P lt; 0.05 (paired t-test). The first group of popliteal lymph node T1WI sequence enhanced scan before and after the SNR to 85.51 ± 15.13; 82.00 ± 12.74, T2WI sequence enhanced scan before and after the SNR 151.01 ± 22.34; 147.19 ± 20.14 GRE T2 * WI sequence enhanced scan around the SNR were 149.77 ± 24.67; 155.09 ± 19.97. The second group of the popliteal lymph node T1WI sequences the enhanced scan before and after the SNR of 92.48 ± 4.98, respectively; 24.68 ± 2.2; T2WI sequences the enhanced scan before and after the SNR for 154.48 ± 16.21; 26.59 ± 3.69; the GRE T2 * WI sequences the enhanced scan before and after the SNR were 152.22 ± 10.74; 3.75 ± 0.68. The use of repeated measures analysis of variance was P lt; 0.01. Conclusion SPIO-enhanced MRI rabbit popliteal lymph nodes injection for intradermal injection in the toe web. The second part of SPIO and Gd-DTPA enhanced MR I metastatic lymph nodes and inflammatory response hyperplastic lymph nodes differential diagnosis of experimental research purposes SPIO lymph nodes with both MRI contrast agent Gd-DTPA diagnosis of benign and malignant lesions, materials and methods equipment and reagents: ① The GE Signa EXCITE 1.5T MRI scanner. ② rabbit scan dedicated coils. ③ eggs, saline. ④ 3% sodium pentobarbital. (5) superparamagnetic iron oxide particles (SPIO). ⑥ 24 New Zealand white rabbits, male and female, regardless of weight 2-2.5kg, were randomly divided into 2 groups. The main experimental steps: (1) the establishment of an animal model: (1) using VX2 malignant tumors grown in the hindlimb muscle of New Zealand white rabbits, about 3-4 weeks popliteal lymph node metastasis. A total of 12 New Zealand white rabbits. ② yolk solution was injected rabbit hind thigh muscles twice about one week popliteal lymph node reactive hyperplasia model. A total of 12 white rabbits. (2) 24 New Zealand white rabbits underwent Gd-DTPA and SPIO-enhanced MRI scan. (3) MRI scan method. Before the use of contrast agents, all animal MRI scan. Scanning sequence T1WI, T2WI, PDWI, GRE T2 * WI. After the end of the scan, the ear vein injection of Gd-DTPA, the line enhanced MRI scan sequence the T1WI STIR sequence. MRI was performed again two days later, the leg toe web intradermal injection of SPIO contrast agent scan after an interval of 12 hours. Scanning sequence T1WI, T2WI, PDWI, GRE T2 * WI. (3) scan after take popliteal lymph node biopsy specimens for pathological examination, HE staining and Prussian blue staining. (4) Please the two imaging diagnosis expert (10 years), in the cases do not know the results of the pathological examination lymph qualitative diagnosis. (5) statistical analysis, including the area under the Kappa test and ROC curve analysis. Results The two groups of lymph node size (x ± s) were (9.50 ± 0.57) mm, (9.65 ± 0.59) mm. The two-sample t-test results showed no difference (p = 0.651, gt; 0.05), two groups of lymph node size. Plain, all the lymph nodes in each sequence signal significant differences. Muscle signal as a reference the T1WI lymph node showed low signal or slightly higher signal sequence; T2WI sequence lymph nodes showed signal or high signal; PDWI lymph nodes showed slightly higher signal sequence; GRE T2 * WI sequence lymph nodes showed signal or high signal. Gd-DTPA enhanced scan, two groups of lymph nodes appear homogeneous or heterogeneous enhancement; SPIO enhanced scan, the tumor group most of the lymph node signal enhanced before and after each scan sequence no significant changes in individual lymph nodes in the the T2WI, PDWI and GRE T2 * WI sequence patchy low signal Ying. Reactive hyperplastic lymph nodes in T1WI, T2WI, PDWI GRE T2 * WI sequence of low signal in GRE T2 * WI sequence even over dose artifacts. After two imaging department physician diagnosis, and pathological findings. Check SPIO-enhanced sensitivity and specificity were 83.3%; Gd-DTPA enhanced inspection sensitivity and specificity were 58.3% and 66.7%. Youden index (YI) were 67%, 25%. SPIO enhanced the group positive predictive value and negative predictive value are 83.3%; positive predictive value and negative predictive value of Gd-DTPA enhanced group were 63.6%, 61.5%. SPIO-enhanced examination and pathological examination Kappa = 0.667, P = 0.01 lt; 0.05; Gd-DTPA-enhanced MRI and pathological examination Kappa = 0.25, P = 0.21 gt; 0.05: SPIO-enhanced MRI with Gd-DTPA-enhanced MRI Kappa = 0.250, P = 0.219 gt; 0.05. The two methods of area under ROC curve were 0.833,0.625, P values ??were 0.006,0.299. Conclusion SPIO is a new MRI contrast agents, compared with Gd-DTPA contrast agent with high specificity and sensitivity of experimental animal models of metastatic lymph nodes and inflammatory response hyperplastic lymph differential diagnosis.

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