DWI及ADC值对胃癌转移淋巴结的诊断价值

发布时间：2018-04-27 18:54

本文选题：胃癌 + 淋巴结　；参考：《临床放射学杂志》2017年09期

【摘要】：目的探究磁共振扩散加权成像(DWI)及表观扩散系数(ADC)值对胃癌转移性淋巴结的鉴别诊断价值。方法搜集26例行常规MR及DWI检查,后经胃镜组织活检证实为胃癌的影像学资料,以术后病理结果为金标准,测量转移性、非转移性淋巴结的短径、长径、相对ADC值(r ADC)(平均ADC值/右肾门水平右侧竖脊肌ADC值),以上指标通过受试者工作特征曲线(ROC)曲线下面积(Az)来比较其在区别胃癌转移性、非转移性淋巴结的诊断效能。结果 DWI图像与手术后组织病理对照,其中53枚是转移性的、67枚是非转移性的淋巴结,转移性、非转移性淋巴结的短径、长径对比,二者之间差异无统计学意义(P0.05);而转移淋巴结的r ADC值(0.719±0.075)低于非转移淋巴结的r ADC值(0.977±0.079),二者之间差异有统计学意义(P=0.000)。r ADC阈值=0.807,其敏感性、特异性、准确性、阳性预测值、阴性预测值分别为79.2%、73.1%、80.2%、82.2%、81.6%,诊断效能最高。结论 DWI及ADC值能很好地鉴别胃癌转移与非转移淋巴结,与常规MR序列相比,DWI能提供更多生理学和功能学信息,以协助临床诊断。
[Abstract]:Objective to investigate the value of diffusion weighted Mr imaging (DWI) and apparent diffusion coefficient (ADCC) in the differential diagnosis of metastatic lymph nodes of gastric cancer. Methods the imaging data of 26 cases of gastric cancer confirmed by gastroscopy tissue biopsy were collected by routine Mr and DWI examination. The short and long diameter of metastatic and non-metastatic lymph nodes were measured according to the results of postoperative pathology as gold standard. The relative ADC value (mean ADC value / ADC value of the right spinal muscle of the right hilar level) was compared by using the area under the operating characteristic curve of the subjects to distinguish the metastatic and non-metastatic lymph nodes of gastric cancer. Results DWI images were compared with postoperative histopathology. Among them, 53 were metastatic lymph nodes, 67 non-metastatic lymph nodes, metastatic lymph nodes and non-metastatic lymph nodes with short diameter and long diameter. There was no significant difference between the two groups (P < 0. 05), but the r ADC value of metastatic lymph nodes (0. 719 卤0. 075) was lower than that of non metastatic lymph nodes (r ADC = 0. 977 卤0. 079). The difference between the two groups was statistically significant (P 0. 000). The threshold value of r ADC was 0. 807. Its sensitivity, specificity, accuracy and positive predictive value were significant. The negative predictive values were 79.2 and 73.1, and 82.2 and 82.2, respectively. The diagnostic efficacy was the highest. Conclusion DWI and ADC values can distinguish metastatic and non-metastatic lymph nodes from gastric carcinoma. Compared with conventional Mr sequences, DWI can provide more physiological and functional information to assist clinical diagnosis.
【作者单位】：宁夏医科大学;宁夏医科大学总医院放射科;
【基金】：宁夏自然基金项目(基金号:NZ14145) 2015宁夏研究生教育创新计划项目(编号:NXYC201511)
【分类号】：R445.2;R735.2

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