摘要
目的探究高分辨率磁共振成像(HR-MRI)联合弥散加权成像(DWI)指导直肠癌盆腔侧方淋巴结转移(PLLNM)诊断的价值。方法选取2021年3月至2024年3月医院收治的86例直肠癌患者作为研究对象,所有患者均进行HR-MRI检查与DWI扫描,以病理结果为金标准,绘制受试者工作特征(ROC)曲线分析HR-MRI、DWI及联合对于直肠癌PLLNM的诊断价值。结果经病理学检查,86例直肠癌患者共检出627个淋巴结,其中481个淋巴结经影像学检查后与病理检查一致,故共计纳入481个淋巴结进行分析。481个淋巴结中恶性淋巴结163个,短径为(6.28±1.88)mm,良性淋巴结318个,短径为(2.55±0.74)mm。HR-MRI检查结果显示481个淋巴结中共211个恶性淋巴结,270个良性淋巴结;DWI检查结果显示481个淋巴结中共207个恶性淋巴结,274个良性淋巴结;HR-MRI联合DWI检查结果显示481个淋巴结中共191个恶性淋巴结,290个良性淋巴结;ROC曲线分析结果显示:HR-MRI、DWI诊断直肠癌PLLNM的曲线下面积(AUC)值分别为0.831、0.847,敏感度分别为85.28%、88.96%,特异度分别为77.36%、80.50%,联合后AUC值为0.919,敏感度、特异度分别为95.09%、88.68%,与HRMRI、DWI单一诊断的ROC曲线比较具有显著性差异(Z=7.194、4.745,P<0.001)。结论HR-MRI联合DWI在直肠癌PLLNM中诊断效能佳,在直肠癌PLLNM诊断中具有良好的指导意义。
Objective To explore the diagnostic value of high-resolution magnetic resonance imaging(HR-MRI)combined with diffusion-weighted imaging(DWI)for pelvic lateral lymph node metastasis(PLLNM)in rectal cancer.Methods A total of 86 patients with rectal cancer admitted to the hospital from March 2021 to March 2024 were selected as the research subjects.All of them underwent HR-MRI examination and DWI scan.Pathological results were used as the gold standard,and the receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of HR-MRI,DWI,and their combination for PLLNM in rectal cancer.Results Pathological examination found 627 lymph nodes in the 86 patients with rectal cancer.Among them,481 lymph nodes detected by imaging examination were consistent with pathological results.Therefore,a total of 481 lymph nodes were analyzed.Among the 481 lymph nodes,there were 163 malignant lymph nodes and 318 benign lymph nodes.The short diameters were(6.28±1.88)mm and(2.55±0.74)mm,respectively.HR-MRI examination results showed that there were 211 malignant lymph nodes and 270 benign lymph nodes among the 481 lymph nodes.DWI examination results showed that there were 207 malignant lymph nodes and 274 benign lymph nodes among the 481 lymph nodes.HR-MRI combined with DWI examination results showed that there were 191 malignant lymph nodes and 290 benign lymph nodes among the 481 lymph nodes.ROC curve analysis results showed that the areas under the curve(AUC)of HR-MRI and DWI for diagnosing PLLNM in rectal cancer were 0.831 and 0.847.The sensitivity was 85.28%and 88.96%.The specificity was 77.36%and 80.50%.The AUC,sensitivity and specificity of combination of the two methods were 0.919,95.09%and 88.68%.There were significant differences as compared with HR-MRI and DWI(Z=7.194,4.745,P<0.001).Conclusion HR-MRI combined with DWI demonstrates good diagnostic efficacy for PLLNM in rectal cancer.
作者
章明明
李慧芝
张翔宇
武宜
ZHANG Ming-ming;LI Hui-zhi;ZHANG Xiang-yu;WU Yi(MRI Room,Shanxi Provincial Integrated TCM and WM Hospital,Taiyuan 030013,Shanxi Province,China)
出处
《中国CT和MRI杂志》
2025年第8期158-160,共3页
Chinese Journal of CT and MRI
基金
山西省卫生健康委科研课题计划(2019087)。
关键词
直肠癌
淋巴结转移
高分辨率磁共振成像
弥散加权成像
诊断
Rectal Cancer
Lymph Node Metastasis
High-resolution Magnetic Resonance Imaging
Diffusion-weighted Imaging
Diagnosis
