中国医学影像学杂志
中國醫學影像學雜誌
중국의학영상학잡지
CHINESE JOURNAL OF MEDICAL IMAGING
2013年
3期
227-230
,共4页
子宫内膜肿瘤%淋巴结%淋巴转移%磁共振成像%扩散加权成像%表观弥散系数%诊断,鉴别
子宮內膜腫瘤%淋巴結%淋巴轉移%磁共振成像%擴散加權成像%錶觀瀰散繫數%診斷,鑒彆
자궁내막종류%림파결%림파전이%자공진성상%확산가권성상%표관미산계수%진단,감별
Endometrial neoplasms%Lymph nodes%Lymphatic metastasis%Magnetic resonance imaging%Diffusion weighted imaging%Apparent diffusion coefficient%Diagnosis, differential
目的比较常规MR序列与扩散加权成像(DWI)判断子宫内膜癌盆腔淋巴结性质的准确性,评价表观扩散系数(ADC)值与细胞密度的相关性.资料与方法55例经手术病理证实的子宫内膜癌患者行常规MR序列和DWI检查,依照病理结果将盆腔淋巴结分为转移性淋巴结(转移组)和炎性淋巴结(炎性组).在T2WI上测量两组淋巴结的大小,在T2WI、DWI和ADC图上测量其信号强度和ADC值,以病理结果为标准,评价长径(L)、短径(S)、长/短径(L/S)、T2WI上信号强度(SIT2WI)、DWI上信号强度(SIDWI)和ADC值对淋巴结性质的诊断效能,并分析ADC值与细胞密度的相关性.结果55例患者共检出57枚转移性淋巴结和102枚炎性淋巴结,两组淋巴结大小及T2WI和DWI上信号强度差异均无统计学意义(L:t=1.63;S:t=2.09;L/S:t=―1.59;SIT2WI:t=―0.97;SIDWI:t=―0.74;P>0.05);转移组ADC值明显低于炎性组(t=-8.73, P<0.001).当ADC值取1.04×10-3 mm2/s时,诊断效能最大,其诊断敏感度、特异度、阳性预测值、阴性预测值和准确度分别为93%、93%、95%、90%、93%;两组淋巴结ADC值与细胞密度呈负相关(r=-0.674, P<0.001).结论ADC值对子宫内膜癌盆腔淋巴结是否转移具有较高的诊断价值,细胞密度可能是影响两组淋巴结ADC值差异的关键因素.
目的比較常規MR序列與擴散加權成像(DWI)判斷子宮內膜癌盆腔淋巴結性質的準確性,評價錶觀擴散繫數(ADC)值與細胞密度的相關性.資料與方法55例經手術病理證實的子宮內膜癌患者行常規MR序列和DWI檢查,依照病理結果將盆腔淋巴結分為轉移性淋巴結(轉移組)和炎性淋巴結(炎性組).在T2WI上測量兩組淋巴結的大小,在T2WI、DWI和ADC圖上測量其信號彊度和ADC值,以病理結果為標準,評價長徑(L)、短徑(S)、長/短徑(L/S)、T2WI上信號彊度(SIT2WI)、DWI上信號彊度(SIDWI)和ADC值對淋巴結性質的診斷效能,併分析ADC值與細胞密度的相關性.結果55例患者共檢齣57枚轉移性淋巴結和102枚炎性淋巴結,兩組淋巴結大小及T2WI和DWI上信號彊度差異均無統計學意義(L:t=1.63;S:t=2.09;L/S:t=―1.59;SIT2WI:t=―0.97;SIDWI:t=―0.74;P>0.05);轉移組ADC值明顯低于炎性組(t=-8.73, P<0.001).噹ADC值取1.04×10-3 mm2/s時,診斷效能最大,其診斷敏感度、特異度、暘性預測值、陰性預測值和準確度分彆為93%、93%、95%、90%、93%;兩組淋巴結ADC值與細胞密度呈負相關(r=-0.674, P<0.001).結論ADC值對子宮內膜癌盆腔淋巴結是否轉移具有較高的診斷價值,細胞密度可能是影響兩組淋巴結ADC值差異的關鍵因素.
목적비교상규MR서렬여확산가권성상(DWI)판단자궁내막암분강림파결성질적준학성,평개표관확산계수(ADC)치여세포밀도적상관성.자료여방법55례경수술병리증실적자궁내막암환자행상규MR서렬화DWI검사,의조병리결과장분강림파결분위전이성림파결(전이조)화염성림파결(염성조).재T2WI상측량량조림파결적대소,재T2WI、DWI화ADC도상측량기신호강도화ADC치,이병리결과위표준,평개장경(L)、단경(S)、장/단경(L/S)、T2WI상신호강도(SIT2WI)、DWI상신호강도(SIDWI)화ADC치대림파결성질적진단효능,병분석ADC치여세포밀도적상관성.결과55례환자공검출57매전이성림파결화102매염성림파결,량조림파결대소급T2WI화DWI상신호강도차이균무통계학의의(L:t=1.63;S:t=2.09;L/S:t=―1.59;SIT2WI:t=―0.97;SIDWI:t=―0.74;P>0.05);전이조ADC치명현저우염성조(t=-8.73, P<0.001).당ADC치취1.04×10-3 mm2/s시,진단효능최대,기진단민감도、특이도、양성예측치、음성예측치화준학도분별위93%、93%、95%、90%、93%;량조림파결ADC치여세포밀도정부상관(r=-0.674, P<0.001).결론ADC치대자궁내막암분강림파결시부전이구유교고적진단개치,세포밀도가능시영향량조림파결ADC치차이적관건인소.
Purpose To compare the accuracy of routine MR and diffusion-weighted imaging (DWI) in the qualitative diagnosis of pelvic lymph nodes in patients with endometrial cancer, and to evaluate the relationship between apparent diffusion coefficient (ADC) value and the cellularity. Materials and Methods Fifty-five patients with pathologically proven endometrial cancer underwent routine MRI and DWI. All patients were divided into metastatic lymph nodes (metastatic group) and inflammatory lymph nodes (inflammatory group) according to the histopathology. The size of lymph nodes in both groups were measured on T2WI, the signal intensity and ADC value were measured on T2WI, DWI and ADC map. With pathology as the criteria, the quantitative diagnosis of long diameter (L), short diameter (S), L/S, signal intensity on T2WI and DWI (SIT2WI, SIDWI) and ADC value was evaluated, and the correlation between ADC value and cell density was analyzed. Results 57 metastatic pelvic lymph nodes and 102 inflammatory lymph nodes were detected in 55 patients. No difference in the size, signal intensity on T2WI or DWI was observed between the two groups (L: t=1.63;S t=2.09; L/S: t= -1.59;SIT2WI:t=-0.97;SIDWI:t=-0.74, P>0.05). The ADC value of the metastatic group was statistically lower than that of inflammatory group of both groups (t=-8.73, P<0.001). When the ADC value was 1.04×10-3 mm2/s, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 93%, 93%, 95%, 90%, 93%, respectively. There was a negative correlation between ADC value and cell density (r=-0.674, P<0.001). Conclusion ADC value has a high diagnostic efficacy in differentiating metastatic pelvic lymph nodes in patient with endometrial cancer. Cell density may be the most important factor that affects the discrepancy of ADC value of lymph nodes between the two groups.
