Study On Clinical Application Of Magnetic Resonance Whole Body Diffusion Weighted Imaging In Malignant Lymphoma

Objective: (1) To compare the display capability of lymphoma lesions between the whole body diffusion-weighted imaging (WB-DWI) and the conventional combined imaging examinations (B ultrasound, chest and abdomen combined CT, PET-CT, etc.),assess the value of WB-DWI or the apparent diffusion coefficient (ADC) in the chemotherapeutic effects of malignant lymphoma. (2) To investigate the potential capacity of WB-DWI in the differential diagnosis of cervical lymph nodes.Materials and methods: (1) 15 patients diagnosed pathologically with malignant lymphoma were received the WB-DWI scan, the display capability of lesions were compared with conventional combined imaging examinations. All the patients had accepted the WB-DWI scan separately in the stages of pre-treatment, early-treatment and post-treatmen, and the ADC values of the lesions were measured, The defference of the ADC value at each times were assessed statistically. (2) 15 healthy volunteers, and 12 patients newly diagnosed with malignant lymphoma and metastatic cervical nodes were received the WB-DWI scan. Measured the ADC values of cervical lymph nodes including the benign lymph nodes and the lymphomatous lymph nodes. the ADC values of different kinds of lymph nodes were compared statistically.Results: (1)43 nodal and extranodal lesions detected by conventional methods were visualized on the map of DWB-DWI with the coincidence rate of 100%. The average ADC values of pre-treatment, early-treatment and post-treatmen were 0.8517±0.4107×10-3 mm2 / s, 1.1496±0.5119×10-3 mm2 / s, 1.5797±0.5933×10-3 mm2 / s, means that the ADC values of each time followed by incremental. Repeated measures design variance analysis showed that there was significant difference in ADC values for each time point (P <0.001). The ADC values at the early stage after chemotherapy changed significantly, happened much earlier than the morphological changes with a prior clue on the treatment effects of chemotherapy. (2) In cervical region, the ADC values of benign lymph nodes, NHL lymphomatous lymph nodes and HD lymphomatous lymph nodes were 0.8565±0.1425×10-3 mm2 / s, 0.5704±0.0512×10-3 mm2 / s,1.2010±0.2982×10-3 mm2 / s, The ADC values among the three groups had significant difference (P <0.001). There was also a difference between the ADC values of lymph node in different kinds of pathological type.The ADC values of HD involved lymph nodes lymphomatous lymph nodes was significantly higher than the NHL lymphomatous lymph nodes.Conclusions: (1)The display ability in finding lymphoma lesions of WB-DWI technology is similar to the conventional combined imaging examinations .The ADC value may give a prior clue on the treatment effects of chemotherapy in lymphoma. (2)The WB-DWI can provide a supplementary diagnostic information for the differential diagnosis of benign and malignant lymphomatous lymph nodes.