摘要
目的分析磁共振成像(MR)不同序列(T1WI、T2WI、DWI)对子宫内膜癌盆腔淋巴结转移的诊断价值。方法选择郑州市中心医院2023年3月至2025年3月收治的150例子宫内膜癌患者作为研究对象,均行MR不同序列(T1WI、T2WI、DWI)检查。以病理检查结果作为金标准,对比转移淋巴结T1WI、T2WI、DWI检出的淋巴结大小以及转移淋巴结与非转移淋巴结DWI下不同b值时的表现弥散系数(ADC)值,并分析T1WI、T2WI、DWI对盆腔淋巴结转移的诊断效能。结果150例子宫内膜癌患者病理检查显示淋巴结302枚,直径10~25 mm,平均(17.44±5.81)mm,其中转移淋巴结104枚(34.44%)、非转移淋巴结198枚(65.56%)。T1W1序列检出的淋巴结短径较T2W1序列和DWI大(P<0.05);T2W1序列和DWI检出的淋巴结短径比较,差异无统计学意义(P>0.05)。转移淋巴结在不同b值时的ADC值均较非转移淋巴结高(P<0.05)。DWI对子宫内膜癌盆腔淋巴结转移的诊断准确性、灵敏度、特异度均较T1WI、T2WI高(P<0.05);T1WI与T2WI的诊断准确性、灵敏度、特异度比较,差异无统计学意义(P>0.05)。结论DWI对子宫内膜癌盆腔淋巴结转移的诊断准确性、灵敏度、特异度均高于T1WI、T2WI,但在评估淋巴结大小方面,DWI与T2WI相比无显著差异。因此,临床实践中应综合应用多种MR序列并结合患者具体情况,以期实现对子宫内膜癌盆腔淋巴结转移的最优诊断。
Objective To analyze the diagnostic value of different magnetic resonance imaging(MR)sequences[T1-weighted imaging(T1WI),T2-weighted imaging(T2WI),diffusion-weighted imaging(DWI)]for pelvic lymph node metastasis of endometrial cancer.Methods A total of 150 patients with endometrial cancer admitted to Zhengzhou Central Hospital from March 2023 to March 2025 were selected as the study subjects.All patients underwent MR examinations with different sequences(T1WI,T2WI,DWI).Using pathological results as the gold standard,the lymph node sizes detected by T1WI,T2WI,and DWI in metastatic lymph nodes,as well as the apparent diffusion coefficient(ADC)values of metastatic and non-metastatic lymph nodes under different b-values on DWI were compared,the diagnostic efficacy of T1WI,T2WI,and DWI for pelvic lymph node metastasis was analyzed.Results Pathological examination of 150 patients with endometrial cancer showed 302 lymph nodes,with diameters ranging from 10 to 25 mm and an average diameter of(17.44±5.81)mm.Among these,there were 104 metastatic lymph nodes(34.44%)and 198 non-metastatic lymph nodes(65.56%).The short diameter of lymph nodes detected by T1W1 sequence was larger than that detected by T2W1 sequence and DWI(P<0.05),but no statistically significant difference showed in the short diameter of lymph nodes detected by T2W1 sequence and DWI(P>0.05).The ADC values of metastatic lymph nodes were higher than those of non-metastatic lymph nodes at different b-values(P<0.05).The diagnostic accuracy,sensitivity,and specificity of DWI for pelvic lymph node metastasis of endometrial carcinoma were higher than those of T1WI and T2WI(P<0.05),there was no statistically significant difference in the diagnostic accuracy,sensitivity,and specificity between T1WI and T2WI(P>0.05).Conclusions DWI demonstrates higher diagnostic accuracy,sensitivity,and specificity for detecting pelvic lymph node metastasis of endometrial cancer compared to T1WI and T2WI,but no significant difference shows between DWI and T2WI in evaluating lymph node size.Therefore,in clinical practice,multiple MR sequences should be used in combination with individual patient conditions to achieve optimal diagnosis of pelvic lymph node metastasis of endometrial cancer.
作者
张森磊
闫广伟
ZHANG Senlei;YAN Guangwei(Department of Radiology,Zhengzhou Central Hospital,Zhengzhou 450000,China;Department of Pathology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《临床医学工程》
2025年第12期1321-1324,共4页
Clinical Medicine & Engineering
基金
河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20210436)。
关键词
磁共振成像
弥散加权成像
子宫内膜癌
盆腔淋巴结转移
诊断价值
Magnetic resonance imaging
Diffusion weighted imaging
Endometrial cancer
Pelvic lymph node metastasis
Diagnostic value
