| 贺伟,周新华,贺文,徐金萍,过丽芳.磁共振弥散加权成像诊断肺癌淋巴结转移[J].中国医学影像技术,2011,27(10):2013~2016 |
| 磁共振弥散加权成像诊断肺癌淋巴结转移 |
| Value of diffusion weighted imaging in diagnosis of metastatic lymph nodes in lung cancer |
| 投稿时间：2011-04-06 修订日期：2011-07-02 |
| DOI： |
| 中文关键词: 扩散磁共振成像 肺肿瘤 肿瘤转移 淋巴结 |
| 英文关键词:Diffusion magnetic resonance imaging Lung neoplasms Neoplasm metastasis Lymph nodes |
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| 中文摘要: |
| 目的 评价DWI诊断肺癌淋巴结转移的价值,探讨ADC值对胸部转移性淋巴结的诊断阈值。方法 对12例肺癌患者术前采用基于阵列空间敏感性编码(ASSET)技术的短反转时间反转恢复(STIR-SE-EPI)序列行MR常规扫描和DWI扫描,将结果与术后淋巴结病理结果进行对照,对转移性和非转移性淋巴结的ADC值、eADC值进行比较。采用ROC曲线分析ADC值鉴别转移性与非转移性淋巴结的诊断价值。结果 12例患者共检出 72个胸部淋巴结。56个手术切除的胸部淋巴结中,34个为转移性淋巴结,22个为非转移性淋巴结。转移性胸部淋巴结的ADC值 明显低于非转移性淋巴结 ,eADC值 高于非转移性淋巴结 。以ADC值≤3.225×10-3 mm2/s作为诊断淋巴结转移的阈值,其敏感度、特异度、阴性预测值、阳性预测值和准确率分别为52.90%、81.81%、52.90%、81.80%、64.32%。结论 应用ASSET技术及STIR-SE-EPI序列获取胸部淋巴结的DWI和ADC值,对诊断及鉴别肺癌淋巴结转移有一定价值。 |
| 英文摘要: |
| Objective To investigate the value of DWI in diagnosis of metastatic lymph nodes in lung cancer, and to explore the diagnostic threshold of ADC. Methods In 12 lung cancer patients before surgical operation, conventional MRI and DWI with array spatial sensitivity encoding technique (ASSET) and short-tau inversion recovery-spin echo-echo planar imaging (STIR-SE-EPI) were performed. According to the surgical maps of the chest lymph nodes which performed within 20 days after MR examination, the ADC and exponential apparent diffusion coefficient (eADC) were compared between the metastatic and nonmetastatic lymph nodes, and ROC analysis was performed to evaluate the diagnostic performance of the ADC in differentiating metastatic from nonmetastatic lymph nodes. Results Seventy-two lymph nodes were found in DWI of 12 patients. Thirty-four metastatic lymph nodes and 22 nonmetastatic ones were found in 56 dissected lymph node. The ADC in the metastatic lymph nodes was (3.03±0.70)×10-3 mm2/s, significantly lower than that of nonmetastatic lymph nodes ( ×10-3 mm2/s, P<0.01). The eADC was significantly higher in the metastatic lymph nodes ( ×10-2) than that of the nonmetastatic lymph nodes ( ×10-2, P<0.05). Setting ADC ≤3.225×10-3 mm2/s as the threshold, the sensitivity and specificity of ADC for differentiating metastatic from nonmetastatic lymph nodes was 52.90% and 81.81%, respectively. The negative and positive predictive values was 52.90% and 81.80%, respectively. The accuracy was 64.32%. Conclusion ASSET and STIR-SE-EPI are feasible for chest lymph nodes imaging, being helpful for differentiation of metastatic and nonmetastatic lymph nodes in lung cancer patients before operation. |
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