摘要
目的 对比3.0T与1.5T磁共振扩散加权成像（DWI）对胃癌淋巴结转移的诊断价值.方法采用Siemens 1.5T及3.0T超导磁共振成像系统分别对50例胃癌患者行术前磁共振检查,并与术后病理结果进行比较,分析1.5T和3.0T磁共振DWI诊断胃癌淋巴结转移的敏感性、特异性、准确率,并对两种方法检测的淋巴结表观扩散系数（ADC）值进行评价.结果1.5T磁共振DWI诊断淋巴结转移的敏感度、特异度及准确率分别为79.4%、81.4%、80.0%;3.0 T磁共振DWI分别为84.6%、79.7%、83.1%.3.0T磁共振DWI诊断胃癌淋巴结转移的准确率略高于1.5T磁共振DWI（χ2=5.451,P=0.020）,但两组的敏感性、特异性比较差异均无统计学意义（均P〉0.05）.1.5T磁共振DWI诊断胃癌淋巴结转移的准确率低于病理诊断（χ2=7.410,P=0.007）,3.0T磁共振DWI的准确率与病理诊断比较差异无统计学意义（χ2=2.450,P=0.120）.1.5T磁共振DWI检测转移、非转移淋巴结的平均ADC值分别为（1.036±0.203）×10-3 mm2/s、（1.476±0.215）×10-3 mm2/s（t=6.813,P〈0.001）;3.0T磁共振DWI分别为（1.154±0.183）×10-3 mm2/s、（1.502±0.264）×10-3 mm2/s（t=5.991,P〈0.001）.两种方法对淋巴结ADC值检测结果的一致性较好.结论3.0T磁共振DWI对胃癌淋巴结转移的诊断效果优于1.5T磁共振DWI,ADC值是评价胃癌淋巴结是否转移的可靠影像学量化指标,对临床手术、治疗方案的选择及患者的预后具有重要意义.
Objective To compare the diagnostic value of 3.0T and 1.5T magnetic resonance diffusion weighted imaging （DWI） in lymph node metastasis of gastric cancer. Methods Preoperative magnetic resonance examination was performed on 50 patients with gastric cancer by using Siemens 1.5T and 3.0T superconducting magnetic resonance imaging system, and the outcomes were compared with postoperative pathological results. The sensitivity, specificity and accuracy of the diagnosis in lymph node metastasis of gastric cancer were analyzed statistically. The apparent diffusion coefficient （ADC） values of lymph nodes were also evaluated for 1.5T and 3.0T magnetic resonance DWI. Results The sensitivity, specificity and accuracy of the diagnosis on lymph node metastasis of gastric cancer by 1.5T magnetic resonance DWI were 79.4 %, 81.4%and 80.0%, respectively, and the corresponding percentages of 3.0T magnetic resonance DWI were 84.6%, 79.7%and 83.1%. The accuracy rate of 3.0T magnetic resonance DWI was slightly higher than that of 1.5T in the diagnosis of lymph node metastasis of gastric cancer （χ2=5.451, P=0.020）, but there were no significant differences in the sensitivity and specificity between the two groups （both P〉 0.05）. The accuracy rate of 1.5T magnetic resonance DWI in the diagnosis of lymph node metastasis of gastric cancer was less effective than that of the pathological diagnosis （χ2=7.410, P=0.007）, but there was no significant difference between 3.0T magnetic resonance DWI and pathological diagnosis （χ2=2.450, P=0.120）. The mean ADC values of metastatic and non-metastatic lymph nodes detected by 1.5T magnetic resonance DWI were （1.036 ±0.203） × 10-3 mm2/s and （1.476 ± 0.215） × 10-3 mm2/s （t= 6.813, P〈 0.001）, meanwhile, the corresponding values detected by 3.0T magnetic resonance DWI were （1.154 ± 0.183） × 10-3 mm2/s and （1.502 ± 0.264） × 10-3 mm2/s （t= 5.991, P〈 0.001）. The coincidence of the two methods for ADC value was favorable. Conclusions The diagn
出处
《肿瘤研究与临床》
CAS
2017年第3期176-179,共4页
Cancer Research and Clinic
基金
山西省社会发展科技攻关项目（20120313022-1）
关键词
胃肿瘤
淋巴结转移
磁共振成像
扩散加权成像
表观扩散系数
Gastric neoplasms
Lymph node metastasis
Magnetic resonance imaging
Diffusion weighted imaging
Apparent diffusion coefficient
