摘要
目的探讨直肠癌动态对比增强磁共振成像（DCE-MRI）对直肠癌系膜内淋巴结转移的评价价值,以期提高直肠癌MRI术前检查对淋巴结良恶性判断的准确性。方法前瞻性搜集经肠镜病理检查证实为直肠癌、术前行MRI常规检查及DCE-MRI并对其术后标本行MRI检查的患者14例,所有患者均行全直肠系膜切除或直肠癌选择性全系膜切除术,其中男8例,女6例,年龄49-72岁,中位年龄61岁。术前、术后标本MRI图像对所见淋巴结进行对照定位,并取材行病理学检查,分析淋巴结的K-（trans）、Ve、K（ep）值与淋巴结性质之间的相关性。结果 14例直肠癌患者,术后标本MRI共检出淋巴结112枚,通过术前MRI图像与术后标本MRI图像对照,共纳入79枚淋巴结行DCE-MRI定量及定性研究,其中恶性淋巴结20枚,反应性增生淋巴结26枚,正常淋巴结33枚。正常淋巴结、反应性增生淋巴结与恶性淋巴结的K^trans分别为0.145±0.020、0.208±0.022、0.247±0.036,差异有统计学意义（P〈0.05）;Kep值分别为0.479±0.133、0.624±0.105、0.681±0.121,差异有统计学意义（P〈0.05）;Ve值分别为0.333±0.076、0.382±0.093、0.362±0.087,差异无明显统计学意义（P〉0.05）。结论 DCE-MRI对鉴别直肠癌系膜内良恶性淋巴结有一定价值。
Objective To explore the value of dynamic contrast-enhanced magnetic resonance imaging （DCE-MR） in the diagnosis of the character of lymph nodes in the mesorectum,to improve the accuracy of MRI on judging the character of lymph nodes before total mesoreetal surgical excision. Methods 14 Patients with rectal cancer confirmed by pathological biopsy were collected from Gansu Provincial hospital since June 2015 to November 2015. All patients had total mesorectal surgical excision,and all cases were performed by MR routine inspection, DWI and dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） before surgery,and their specimens of eolorectal cancer were examined by MR again. 8 pa- tients were male and 6 patients were female;aged from 49 to 72 ,average age was 61. Results Results The group of 14 patients with rectal cancer, postoperative specimens of MRI were detected in 112 lymph nodes, preoperative MRI images and postoperative MRI images, a total of 79 lymph nodes included DCE MRI quantitative and qualitative studies, including malignant lymph nodes 20, reactive hyperplastic lymph nodes 26, normal lymph nodes 33. The K^trans value of normal,reaerive hyperplastic and malignant lymph nodes were 0. 145 ± 0. 020,0. 208 ＋ 0. 022,0. 247 ± 0. 036 respectively, the difference was statistically significant （ P 〈 0.05 ） ; the K p values were 0. 479 - 0. 133,0. 624 ± 0. 105,0. 681 ± 0. 121, the difference was statistically significant （P 〈 0.05 ） ;the Ve values were 0. 333 ± 0.076,0. 382 ± 0. 093,0. 362 ± 0. 087, the difference between them had no statistical significance （ P 〉 0.05）. Conclusion The dynamic contrast-enhanced magnetic： resonance imaging （DCE-MRI） confirmed significance in distinguishing malignant lymph nodes in the mesorectmn.
出处
《临床放射学杂志》
CSCD
北大核心
2018年第1期94-99,共6页
Journal of Clinical Radiology
基金
甘肃省人民医院院内科研基金项目(编号:16GSSY1-7)
