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目的初步探索皮下应用Gd-DTPA-白蛋白的阳性磁共振淋巴造影检测隐匿转移性淋巴结的价值。方法建立腘窝隐匿转移性淋巴结新西兰兔模型,分析隐匿转移性淋巴结在平扫及皮下注射0.10 mmol/肢Gd-DTPA-白蛋白后24 h时的MRI特征,并与病理检查对照。结果12只兔的腘窝隐匿转移性淋巴结模型成功建立,其淋巴结大小为(6.7±0.2)mm。平扫时隐匿转移性腘窝淋巴结表现为T1WI上等信号,T2WI上高信号,与正常淋巴结相似。Gd-DTPA-白蛋白增强24 h,正常淋巴结呈明显、均匀的强化,而隐匿转移性淋巴结呈不均匀强化,强化形式有环状(4枚淋巴结)、云絮状(3枚)和不规则偏心“充盈缺损”(3枚),另有2枚淋巴结不强化。在脂肪抑制T1WI像上淋巴管呈明亮高信号,转移性淋巴结的引流淋巴管明显迂曲扩张。结论皮下应用Gd-DTPA-白蛋白的阳性MR淋巴造影可清晰显示淋巴结和淋巴管,可用于检测隐匿转移性淋巴结。
Objective To explore the value of subcutaneous Gd-DTPA-albumin positive magnetic resonance lymphadenectomy in the detection of metastatic lymph nodes. Methods New Zealand rabbits with occult metastatic lymph nodes were established in the popliteal fossa. The MRI features of the metastatic lymph nodes were analyzed at 24 h after plain and subcutaneous injection of 0.10 mmol / L Gd-DTPA-albumin, and compared with the pathological examination. Results The model of crypt metastasis of lymph node was successfully established in 12 rabbits. The lymph node size was (6.7 ± 0.2) mm. Metastatic transitional popliteal lymph nodes in plain scan showed T1WI superior signal, high signal on T2WI, similar to normal lymph nodes. Gd-DTPA-albumin enhanced 24 h, the normal lymph nodes were significantly enhanced, while the hidden metastatic lymph nodes were heterogeneous enhancement, enhanced forms of ring (4 lymph nodes), flocculent (3) and irregular Eccentric “filling defects ” (3), and another two lymph nodes is not enhanced. In fat-suppressed T1WI images, lymphatic vessels showed a bright high signal, and the lymphatic vessels of metastatic lymph nodes significantly tortuously expanded. Conclusion Subcutaneous Gd-DTPA-albumin positive MR lymphatic imaging can clearly show lymph nodes and lymphatic vessels, can be used to detect occult metastatic lymph nodes.