中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2014年
3期
225-229
,共5页
周竹萍%何健%刘松%管文贤%包善华%俞海平%周正扬
週竹萍%何健%劉鬆%管文賢%包善華%俞海平%週正颺
주죽평%하건%류송%관문현%포선화%유해평%주정양
胃肿瘤%淋巴结转移%磁共振成像%弥散加权成像%诊断价值
胃腫瘤%淋巴結轉移%磁共振成像%瀰散加權成像%診斷價值
위종류%림파결전이%자공진성상%미산가권성상%진단개치
Stomach neoplasms%Lymph node metastasis%Magnetic resonance imaging%Diffusion weighted imaging%Diagnostic value
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的52例胃癌患者进行磁共振DWI检查,对应术中标记的淋巴结,分别测量淋巴结的表观扩散系数(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)×10-3mm2/s比(1.402±0.285)×10-3mm2/s,P=0.000];以1.189×10-3 mm2/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75.0％(39/52).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) mm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67.3％(35/52).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.
目的 探討術前磁共振瀰散加權成像(DWI)對胃癌淋巴結轉移的診斷價值.方法 對2011年12月至2012年12月間南京大學醫學院附屬鼓樓醫院收治的52例胃癌患者進行磁共振DWI檢查,對應術中標記的淋巴結,分彆測量淋巴結的錶觀擴散繫數(ADC)值及短徑,併與術後病理結果相對照.採用受試者工作特徵麯線(ROC)評價ADC值及短徑對胃癌淋巴結轉移的診斷價值.結果 DWI檢測到轉移性淋巴結180枚,非轉移性淋巴結57枚,均為高信號.DWI上轉移性淋巴結ADC值明顯低于非轉移性淋巴結[(1.059±0.196)×10-3mm2/s比(1.402±0.285)×10-3mm2/s,P=0.000];以1.189×10-3 mm2/s作為ADC值評估轉移性淋巴結的最佳閾值,其敏感度、特異度和麯線下麵積(AUC)分彆為78.9％、72.8％和0.840,其對術前N分期診斷的總體準確率為75.0％(39/52).DWI上轉移性淋巴結短徑明顯長于非轉移性淋巴結[(8.08±3.99) mm比(6.75±2.70) mm,P=0.005];以5.05 mm作為淋巴結短徑評估轉移性淋巴結的最佳閾值時,其敏感度、特異度和AUC分彆為88.3％、29.8％和0.602,其對術前N分期診斷的總體準確率為67.3％(35/52).結論 磁共振DWI對胃癌淋巴結轉移具有較高的診斷價值,以ADC值及淋巴結短徑作為診斷標準可用于術前N分期的診斷.
목적 탐토술전자공진미산가권성상(DWI)대위암림파결전이적진단개치.방법 대2011년12월지2012년12월간남경대학의학원부속고루의원수치적52례위암환자진행자공진DWI검사,대응술중표기적림파결,분별측량림파결적표관확산계수(ADC)치급단경,병여술후병리결과상대조.채용수시자공작특정곡선(ROC)평개ADC치급단경대위암림파결전이적진단개치.결과 DWI검측도전이성림파결180매,비전이성림파결57매,균위고신호.DWI상전이성림파결ADC치명현저우비전이성림파결[(1.059±0.196)×10-3mm2/s비(1.402±0.285)×10-3mm2/s,P=0.000];이1.189×10-3 mm2/s작위ADC치평고전이성림파결적최가역치,기민감도、특이도화곡선하면적(AUC)분별위78.9％、72.8％화0.840,기대술전N분기진단적총체준학솔위75.0％(39/52).DWI상전이성림파결단경명현장우비전이성림파결[(8.08±3.99) mm비(6.75±2.70) mm,P=0.005];이5.05 mm작위림파결단경평고전이성림파결적최가역치시,기민감도、특이도화AUC분별위88.3％、29.8％화0.602,기대술전N분기진단적총체준학솔위67.3％(35/52).결론 자공진DWI대위암림파결전이구유교고적진단개치,이ADC치급림파결단경작위진단표준가용우술전N분기적진단.
Objective To explore the preoperative diagnostic value of MR diffusion weighted imaging(DWI) for metastatic lymph nodes in patients with gastric cancer.Methods Between December 2011 and December 2012,52 gastric cancer patients (34 men,18 women) underwent preoperative MR DWI.The apparent diffusion coefficient (ADC) and short diameter of lymph nodes were measured and compared with the postoperative histopathological findings.Diagnostic value of ADC and short diameter for metastatic lymph nodes in patients with gastric cancer was investigated by receiver characteristic curvc (ROC) analysis.Results A total of 180 metastatic and 57 non-metastatic lymph nodes were detected as hyperintense on DWI obtained from 52 patients.The ADC of metastatic lymph nodes [(1.059±0.196)×10-3 mm2/s] was significantly lower than that of non-metastatic nodes[(1.402±0.285)×10-3 mm2/s,P＜0.001].With ADC threshold of 1.189×10-3 mm2/s,the sensitivity,specificity and area under the curve(AUC) were 78.9％,72.8％ and 0.840,respectively.The overall diagnostic accuracy of preoperative N staging of ADC was 75％(39/52).The short diameter of metastatic lymph nodes [(8.08±3.99) mm] was significantly longer than that of non-metastatic lymph nodes [(6.75±2.70) mm,P=0.005].With short diameter threshold of 5.05 mm,the sensitivity,specificity and AUC were 88.3％,29.8％ and 0.602,respectively.The overall diagnostic accuracy of short diameter in preoperative N staging was 67.3％ (35/52).Conclusions MR DWI is a useful technique in diagnosing metastatic lymph nodes in patients with gastric cancer.ADC value and short diameter can be used as diagnostic criterion for the diagnosis of preoperative N staging.
