Value of MR HASTE sequence scan combined with serum SIRT1 level in the differential diagnosis of mediastinal hilar enlarged lymph nodes

LIU Lijiang; CUI Hongxian; DUAN Jun; WANG Jincai; MENG Qingchun

doi:10.20258/j.cnki.1006-9011.2026.01.013

Abstract：Objective To analyze the value of magnetic resonance(MR)half-Fourier acquisition single-shot fast spin echo(HASTE)sequence scanning combined with serum silent information regulator 1(SIRT1)in the differential diagnosis of medias-tinal hilar lymph nodes.Methods A total of 120 patients(149 lymph nodes)who underwent mediastinal and hilar MRI were selected as the modeling set.Additionally,51 patients(65 lymph nodes)who underwent MR examinations of the mediastinum and hilar region were selected as the external validation dataset.The clinical pathological results of the 120 patients were statisti-cally analyzed to compare the MR manifestations and serum SIRT1 levels of lymph nodes with different properties.LOO Oogistic regression models were used to analyze the influencing factors of lymph node malignancy.ROC curves were employed to evaluate the diagnostic value of MR manifestations and serum SIRT1 levels for lymph node properties individually and in combination.The consistency between the diagnostic results of the combined diagnostic model and the clinical pathological results was ana-lyzed using the Kappa value.Results A total of 149 lymph nodes were detected in 120 patients.Pathological examination showed 104(69.80%)malignant lymph node metastases and 45(30.20%)benign lesions.The short diameter of malignant lymph nodes(13.48±2.01)mm was larger than that of benign lymph nodes(9.16±2.74)mm.The proportions of high signal in-tensity on DWI,high signal intensity on T2-weighted imaging(T2WI),and low signal intensity on T1-weighted imaging(T1WI)were 80.77%,75.00%,and 76.92%,respectively,which were higher than those in benign lymph nodes(60.00%,51.11%,and 46.67%).The serum SIRT1 level(4.98±1.65)ng/mL was lower than that in benign lymph nodes(8.04±2.66)ng/mL,and the differences were statistically significant(all P<0.05).The results of logistic regression model analysis showed that short diam-eter,high signal intensity on DWI,high signal intensity on T2WI,and low signal intensity on T1WI were risk factors for malig-nant lymph node lesions,while elevated SIRT1 was a protective factor(all P<0.05).ROC analysis showed that the area under the curve(AUC)of short diameter,high signal intensity on DWI,high signal intensity on T2WI,low signal intensity on T1WI,and SIRT1 for diagnosing lymph node properties ranged from 0.604 to 0.744.The AUC of combined diagnosis using these vari-ables was 0.891,significantly higher than that of single variable diagnosis.Consistency analysis showed that the diagnostic re-sults of the combined diagnosis model had a concordance rate of 92.31%with clinical pathological results,with a Kappa value of 0.797.Conclusion MR HASTE sequence combined with serum SIRT1 has good consistency with clinicopathological results in the diagnosis of mediastinal hilar lymph nodes,which can be used as an effective scheme for clinical diagnosis,so as to guide individualized intervention.