40 patients of the first two groups were carried out contrast enhanced CT of the chest,
abdomen and pelvis at least once - in case of mediastinal form of lymphoma only chest CT was performed in follow-up (in case of absence of vascular involvement in the pathological process suspicion contrast enhancement has not been administered).
Whole-body PET was performed in 20 patients of the first 2 groups.
In case of lesions in only one or more contiguous groups of peripheral lymph nodes,
the treatment control was carried out according to the ultrasound and excluded the holding of CT.
Scan area was limited in order to reduce radiation exposure.
For remission confirmation whole-body MRI were performed in all cases.
Average number of whole-body MRI studies for one patient was 4 (from 2 to 8).
In first and second groups four basic types of lymphoma lesions were:
1.
enlarged lymph nodes
2.
package of lymph nodes
3.
conglomerate of lymph nodes
4.
lymphoid infiltrate
The average number of affected lymph nodes in fist two groups was 7 (from 1 group up to total lymph nodes lesion).
In the first group from 30 to 90 involved nodes,
from 1 to 8 diffuse bone lesions,
from 1 to 5 lesions in non lymphoid organs and from 2 to 5 focal lesions,
as a consequence of the inflammatory-sclerotic processes not related to the lymphoproliferative disease were identified.
In the second group from 20 to 60 specific focal lesions,
1 up to multiple diffuse bone changes,
from 2 up to innumerable lesions in non lymphoid organs and from 2 to 3 local changes estimated as consequences of nonspecific inflammatory-sclerotic processes of bones were found.
In several patients of first two groups,
who received prolonged courses of chemotherapy (from 6 to 8),
post chemotherapy bone marrow infarctions were identified only by MRI.
Infarctions were located in long tubular bones - mainly in the femoral bones almost symmetrically on both sides.
In the third group number of detected non-oncologic lesions reached to 5 per person (from chronic somatic illness to severe conditions such as pneumonia).
Reactively enlarged lymph nodes were detected in every third patient,
most frequently in combination with various sinusitis.
In one case disseminated lesion of bone marrow was detected (subsequently histologically proved multiple myeloma).
DWI did not reveal any additional lesions and proved to be not good in mediastinum because of it’s high sensitivity to cardiac motion.
DWI has shown a low sensitivity in spleen lesions because of natural limitations of diffusion processes in this organ. DWI was helpful in estimation of residual lymphoid tissue - signal intensity decreased signal previously to volume.
Subsequent sighting diagnostic studies in all cases did not contradict with whole-body MRI results.
The results of PET in all cases are not contrary to the whole body MRI.
In 3 patients from the first group MRI revealed enlarged and deformed lymph nodes that did not accumulate the radiopharmaceutical in PET (all that lymph nodes normalized after treatment).
Performed CT studies revealed up to 85% lymph node lesions detected with MRI (including 1 patient with intercostal muscles lymph nodes lesion in which CT was absolutely not sensitive).
Local specific bone involvement on CT was differentiated in 5 cases - decomposition of presternum,
ribs and destructive lesions of the vertebral bodies in patients with massive mediastinal lymphoma.
CT clearly differentiated local reactive changes in the loci of iliac biopsy.
Inflammatory and sclerotic changes in cancellous bone CT did not reveal in any case.
Within focal and massive lesions of lung MRI was not inferior to CT in any case.
CT was more sensitive in detection of focal lung lesions less than4,0 mm- that were not differentiated between post inflammatory and specific changes without follow-up.
With whole-body MRI also were suspected few ischemic lesions of cerebral blood flow and one case of specific brain lesions (all confirmed with sighting survey) - that influenced on treatment.
Whole-body MRI clearly detected cases of bile ducts compressions by lymph nodes conglomerates.
Almost every second patient was revealed varying degrees of sinusitis.