磁共振弥散加权成像对胃癌淋巴结转移及N分期的诊断价值

发布时间：2018-06-07 22:13

本文选题：胃肿瘤 + 淋巴结转移　；参考：《南京大学》2014年硕士论文

【摘要】：目的：探讨术前磁共振弥散加权成像(DWI)对胃癌淋巴结转移的诊断价值。方法：对2011年12月至2012年12月间南京大学医学院附属鼓楼医院收治52例胃癌患者进行磁共振DWI检查,对应术中标记的淋巴结,分别测量淋巴结的ADC值及短径,并与术后病理结果相对照。采用受试者工作特征曲线(ROC)评价ADC值及短径对胃癌淋巴结转移的诊断价值。结果：DWI检测到转移性淋巴结180枚,非转移性淋巴结57枚,均为高信号。DWI上转移性淋巴结ADC值明显低于非转移性淋巴结[(1.059±0.196)比(1.402±0.285)×10-3mm2/s,P0.001]；以1.189×10-3mm2/s作为ADC值评估转移性淋巴结的最佳阈值,其敏感度、特异度和曲线下面积(AUC)分别为78.9%、72.8%和0.840,其对术前N分期诊断的总体准确率为80.8%(42/52)。DWI上转移性淋巴结短径明显长于非转移性淋巴结[(8.08±3.99)比(6.75±2.70)mm,P=0.005]；以5.05 mm作为淋巴结短径评估转移性淋巴结的最佳阈值时,其敏感度、特异度和AUC分别为88.3%、29.8%和0.602,其对术前N分期诊断的总体准确率为59.6%(31/52)。结论：磁共振DWI对胃癌淋巴结转移具有较高的诊断价值,以ADC值及淋巴结短径作为诊断标准可用于术前N分期的诊断。
[Abstract]:Objective: to evaluate the diagnostic value of preoperative diffusion weighted Mr imaging (DWI) in lymph node metastasis of gastric cancer. Methods: from December 2011 to December 2012, 52 patients with gastric cancer treated in Gulou Hospital affiliated to Medical College of Nanjing University were examined by DWI. The ADC values and short diameter of lymph nodes were measured respectively. And compared with postoperative pathological results. The value of ADC and short diameter in the diagnosis of lymph node metastasis of gastric cancer was evaluated by means of operating characteristic curve (ROC). Results 180 metastatic lymph nodes and 57 non-metastatic lymph nodes were detected on DWI. The ADC values of metastatic lymph nodes on DWI were significantly lower than those on non-metastatic lymph nodes [1.059 卤0.196] 脳 10 ~ (-3) mm ~ (-2) 路s ~ (-1) P ~ (0.001). 1.189 脳 10-3mm2/s was used as the best threshold for evaluating metastatic lymph nodes. Its sensitivity, The specificity and area under the curve were 72.8% and 0.840%, respectively. The overall diagnostic accuracy of N staging was 80.842%. DWI was significantly longer than that of non-metastatic lymph nodes [8.08 卤3.99] vs 6.75 卤2.70 mm P0.005. When the optimal threshold for sexual lymph nodes, The sensitivity, specificity and AUC were 88.329.8% and 0.602, respectively. Conclusion: DWI has a high diagnostic value for lymph node metastasis of gastric cancer. ADC value and short diameter of lymph node can be used as diagnostic criteria for preoperative N staging of gastric cancer.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R735.2

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