磁共振弥散加权成像用于鉴别胃癌淋巴结转移的研究

发布时间：2018-03-06 08:47

本文选题：胃癌　切入点：磁共振弥散加权成像　出处：《山东中医药大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的研究磁共振弥散加权成像对胃癌淋巴结转移的诊断价值，探讨ADC值对胃癌转移淋巴结与非转移淋巴结鉴别的指导意义。资料与方法回顾性分析经手术病理证实的43例胃癌患者的临床资料及术前MRI图像，测量胃癌转移与非转移淋巴结的长径、短径、最小ADC值以及右肾门层面右侧竖脊肌ADC值，计算相对ADC值（rADC），利用ROC曲线下面积评价上述各项指标鉴别胃癌转移与非转移淋巴结的诊断效能。结果转移淋巴结短径和长径均大于非转移淋巴结，且两者差异具有统计学意义（P＜0.001；P＜0.001）；转移淋巴结的最小ADC值和rADC值均低于非转移淋巴结，且差异均具有统计学意义（P＜0.001；P＜0.001）；短径、长径、最小ADC值和rADC值对鉴别胃癌胃周转移与非转移淋巴结均有诊断意义（Az＞0.5），其中最小ADC值的诊断效能最高，选取最小ADC值阈值为0.878×103mm2/s时，其灵敏度和特异度分别为87.7%和77.4%。转移和非转移淋巴结各ADC值指标与形态学参数均无显著相关性（均为P＞0.05）。结论ADC值能很好的鉴别胃癌转移与非转移淋巴结，以最小ADC值最为敏感，，其诊断效能优于形态学指标。
[Abstract]:Objective to study the diagnostic value of diffusion-weighted magnetic resonance imaging (DWI) in lymph node metastasis of gastric cancer and to explore the significance of ADC value in differentiating metastatic lymph nodes from non-metastatic lymph nodes. Materials and methods the clinical data and preoperative MRI images of 43 patients with gastric cancer confirmed by surgery and pathology were retrospectively analyzed. The long, short and minimal ADC values of metastatic and non-metastatic lymph nodes of gastric cancer were measured, and the ADC values of the right spinal vertical muscles on the right hilum were measured. The relative ADC value was calculated and the area under the ROC curve was used to evaluate the diagnostic efficacy of the above indexes in differentiating metastatic and non-metastatic lymph nodes from gastric cancer. Results the short diameter and long diameter of metastatic lymph nodes were larger than those of non-metastatic lymph nodes, and the difference between them was statistically significant (P < 0.001), the minimum ADC value and rADC value of metastatic lymph nodes were lower than those of non-metastatic lymph nodes, and the differences were statistically significant (P < 0.001), short diameter, long diameter, short diameter, long diameter, long diameter, short diameter and long diameter of metastatic lymph nodes were significantly lower than those of non-metastatic lymph nodes. The minimum ADC value and rADC value have diagnostic significance in differentiating gastric cancer from non-metastatic lymph nodes. The minimum ADC value has the highest diagnostic efficacy. When the minimum ADC threshold is 0.878 脳 10 ~ 3mm ~ 2 / s, there is no significant difference between the minimum ADC value and non-metastatic lymph node, and the minimum ADC value is 0.878 脳 10 ~ 3 mm ~ (2) / s. The sensitivity and specificity were 87.7% and 77.4, respectively. There was no significant correlation between the ADC values of metastatic and non-metastatic lymph nodes and morphological parameters (P > 0.05). Conclusion ADC value can distinguish metastatic and non-metastatic lymph nodes from gastric carcinoma, and the minimum ADC value is the most sensitive one, and its diagnostic efficacy is better than that of morphological index.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R735.2

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