摘要
目的探究3.0T磁共振(Magnetic resonance,MR)弥散加权成像评估胃癌患者淋巴结性质及N分期的临床价值。方法选取2016年10月至2018年9月间牡丹江医学院附属红旗医院普外科收治的39例胃癌患者,以手术淋巴结病理诊断结果为金标准,评估3.0T MR弥散加权成像在判断胃癌患者淋巴结转移性质及N分期的准确性、一致性。结果(1)胃癌淋巴结转移性质:MR弥散加权成像的诊断结果与术后病理具有较好的一致性,准确率可达89.74%(P<0.05),Kappa值为0.811,转移淋巴结表观弥散系数(apparent diffusion coaffcient,ADC)值小于非转移淋巴结ADC值(P值为0.001);(2)MR N分期:与术后病理比较,MR弥散加权成像的b值为500 s/mm 2、1000 s/mm^2、2000 s/mm^2时,MRI评估N分期的准确率分别为58.97%、74.36%和66.67%(P值分别为0.644、0.881、0.801),Kappa值分别为0.380、0.811、0.698。结论MR弥散加权成像对判断胃癌患者淋巴结性质及在评估胃癌N分期中具有一定临床价值。
Objective To explore the clinical value of 3.0T magnetic resonance(MR)diffusion weighted imaging in the determination of lymph node properties and N staging of gastric cancer patients.Methods From October 2016 to September 2018,39 patients with gastric cancer admitted to the Department of General Surgery of Hongqi Hospital affiliated to Mudanjiang Medical College were selected.The pathological diagnosis of surgical lymph nodes was used as the gold standard to evaluate the accuracy and consistency of 3.0T MR diffusion-weighted imaging in determining the status of lymph node metastasis and N stage in patients with gastric cancer.Results(1)The status of lymph node metastasis in gastric cancer:The diagnosis results of MR diffusion weighted imaging had good consistency with postoperative pathology,the accuracy rate can reach 89.74%(P<0.05),the Kappa value was 0.811,and the apparent diffusion coefficient of metastatic lymph nodes apparent diffusion coaffcient(ADC)value was less than ADC value of non-metastatic lymph nodes(P values was 0.01).(2)MR N staging:Compared with postoperative pathology,when the b values of MR diffusion weighted imaging were 500 s/mm 2,1000 s/mm 2,and 2000 s/mm 2,the accuracy rates of MRI evaluation of N staging were 58.97%,74.36%,and 66.67%,respectively(P values were 0.644,0.881,and 0.801,respectively),and Kappa values were 0.380,0.811,and 0.698,respectively.Conclusion MR diffusion-weighted imaging has a certain diagnostic value for gastric cancer lymph node metastasis.In gastric cancer patients,it has high accuracy in judging the nature of lymph nodes and has certain clinical value in N stage.
作者
包权
邢健
刘子航
梁海昱
杨俊强
李洪义
BAO Quan(Hongqi Hospital Affiliated to Mudanjiang Medical University,Department of Magnetic Resonance,Mudanjiang 157011,China)
出处
《牡丹江医学院学报》
2020年第3期92-94,104,共4页
Journal of Mudanjiang Medical University
基金
牡丹江市科学技术计划项目(Z2016s0068)。
关键词
胃癌
弥散加权成像
N分期
病理分期
淋巴结性质
Gastric cancer
Diffusion-weighted imaging
N stage
Pathological stage
Lymph node properties
