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目的比较PET／CT与MRI在鼻咽癌淋巴结转移诊断和N分期中的作用。方法116 例鼻咽癌患者于治疗前行PET／CT和MRI检查。依据随访结果比较PET／CT和MRI在淋巴结转移诊断和N分期中的作用。结果116例患者的614个淋巴结的随访结果显示,阳性340个,阴性274个。 PET／CT诊断转移淋巴结的敏感性、特异性及准确性分别为93．2％、98．2％和95．4％,而MRI分别为 88．8％、91．2％和89．9％,两者各指标比较,差异有统计学意义(P<0．05)。按1992年福州分期,109 例(94．0％)的PET／CT分期正确,103例(88．8％)的MRI分期正确;按UICC分期,108例(93．1％)的 PET／CT分期正确,100例(86．2％)的MRI分期正确。结论PET／CT判断鼻咽癌淋巴结转移和N分期较MRI准确,但对炎性增生、大面积坏死淋巴结,或直径小于PET空间分辨率的转移淋巴结应警惕其假阳性和假阴性判断。
Objective To compare the role of PET / CT and MRI in the diagnosis of lymph node metastasis and N stage in nasopharyngeal carcinoma. Methods 116 patients with nasopharyngeal carcinoma were examined with PET / CT and MRI before treatment. According to the results of follow-up PET / CT and MRI in the diagnosis of lymph node metastasis and the role of N stage. Results The follow-up of 614 lymph nodes in 116 patients showed 340 positives and 274 negatives. The sensitivity, specificity and accuracy of PET / CT in the diagnosis of metastatic lymph nodes were 93.2%, 98.2% and 95.4%, respectively, while those of MRI were 88.8%, 91.2% and 89.9% , The two indicators compared, the difference was statistically significant (P <0.05). According to the 1992 Fuzhou staging, 109 (94.0%) PET / CT staging was correct and 103 (88.8%) MRI staging was correct. According to UICC staging, 108 cases (93.1%) of PET / CT Staging is correct, 100 cases (86.2%) of the MRI staging is correct. Conclusions PET / CT is more accurate than MRI in predicting the lymph node metastasis and N stage of nasopharyngeal carcinoma. However, it is necessary to guard against false positive and false negative lymph nodes metastasis in inflammatory hyperplasia, large area necrotic lymph nodes or smaller than PET spatial resolution.