Schedel H, Vogl T, Hahn D, Mees K, Peer F, Lissner J
Radiologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München.
Digitale Bilddiagn. 1988 Dec;8(4):158-67.
The diagnostic possibilities of magnetic resonance imaging compared with computed tomography in lymphomas and pathological enlargement of the lymph nodes in the head and neck region are presented. Whereas plain MRI examinations showed the same diagnostic sensitivity as CT, application of the paramagnetic contrast medium Gd-DTPA in 50 of 87 patients clearly increased diagnostic accuracy. Signal intensities of T1- or T2-weighted images before therapy (operation, chemotherapy, radiotherapy) and after administration of Gd-DTPA were enhanced, compared with posttherapeutic and plain examinations. An increase after therapy in two patients signalled a relapse or residual tumour tissue; a decrease in three cases was evaluated as response to therapy. Other differential diagnostic processes such as lipomas, neurinomas, glomus tumours etc. were differentiated with the help of signal intensity curves after administration of contrast media and the use of a gradient echo sequence TR/TE = 30/12 msec with a flip angle of 30 degrees. Differentiation of tissue based on morphological criteria such as homogeneity of tumour tissue or the delineation against surrounding tissue structures showed in the case of Hodgkin's disease and inflammatory diseases mainly homogeneous elements without ring-shaped structure. Non-Hodgkin lymphomas had a predominantly homogeneous structure. In squamous cell carcinomas MR revealed in two cases a ring-shaped enhancement.
本文介绍了磁共振成像（MRI）与计算机断层扫描（CT）相比，在淋巴瘤以及头颈部淋巴结病理性肿大诊断中的应用可能性。尽管普通MRI检查显示出与CT相同的诊断敏感性，但在87例患者中的50例应用顺磁性造影剂钆喷酸葡胺（Gd-DTPA）后，诊断准确性明显提高。与治疗后及普通检查相比，治疗（手术、化疗、放疗）前及注射Gd-DTPA后的T1加权或T2加权图像的信号强度增强。两名患者治疗后信号增强提示复发或残留肿瘤组织；三例信号降低被评估为对治疗有反应。其他鉴别诊断过程，如脂肪瘤、神经鞘瘤、球瘤等，可借助注射造影剂后的信号强度曲线以及使用翻转角为30度、TR/TE = 30/12毫秒的梯度回波序列进行区分。基于形态学标准，如肿瘤组织的均匀性或与周围组织结构的界限来区分组织，结果显示，在霍奇金病和炎症性疾病中，主要为无环形结构的均匀成分。非霍奇金淋巴瘤主要具有均匀结构。在鳞状细胞癌中，MRI在两例中显示出环形强化。
