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目的探讨磁共振弥散加权成像技术应用于胃癌淋巴结转移疾病诊断中的分级和临床意义。方法选择该院2013年4月—2015年9月收治的疑诊为胃癌淋巴结转移患者55例,对全部患者进行全身磁共振扩散成像(Whole body magnetic resonance diffusion imaging,WB-DWI)与同期正电子发射断层显像/X线计算机体层成像(Positron emission tomography/X-ray computed tomography,PET/CT)检测。比较两组检测方式诊断胃癌淋巴结转移的分级与临床意义。结果在TNM分级诊断方面,WBDWI(N_X级占比3.64%、N_0级占比10.91%、N_1级占比32.73%、N_2级占比38.18%、N_(3a)级占比9.09%、N_(3b)级占比5.45%)、PET/CT(N_X级1.82%、N_0级9.09%、N_1级29.09%、N_2级41.82%、N_(3a)级10.91%、N_(3b)级7.27%)差异无统计学意义(P>0.05);WB-DWI、PET/CT均有一定误诊情况,两种检测方式的敏感性(分别为92.16%、96.08%)、Youden指数(分别为66.16%、70.08%)、总符合率(分别为90.90%、94.55%)和特异性(分别为75.00%、75.00%)均差异无统计学意义(P>0.05)。结论 WB-DWI和PET/CT在胃癌淋巴结转移的诊断中具有一定可行性,但PET/CT检测费用较高,有一定辐射性,而WB-DWI费用较为低廉,辐射较小,临床应结合实际情况进行选取。
Objective To investigate the classification and clinical significance of MR diffusion weighted imaging in the diagnosis of lymph node metastasis of gastric cancer. Methods Fifty-five patients suspected of gastric cancer with lymph node metastasis were selected from April 2013 to September 2015 in our hospital. Whole body magnetic resonance diffusion imaging (WB-DWI) Emission tomography / X-ray computed tomography (PET / CT) detection. The classification and clinical significance of the detection of lymph node metastasis in two groups were compared. Results In the TNM classification, WBDWI (N_X grade accounted for 3.64%, N_0 grade accounted for 10.91%, N_1 grade accounted for 32.73%, N_2 grade accounted for 38.18%, N_ (3a) grade accounted for 9.09%, N_ (3b ) Accounted for 5.45%), PET / CT (N_X grade 1.82%, N_0 grade 9.09%, N_1 grade 29.09%, N_2 grade 41.82%, N_ (3a) grade 10.91%, N_ (3b) grade 7.27%) There was a certain misdiagnosis of WB-DWI and PET / CT in both groups (92.16% and 96.08%, respectively), and Youden index (66.16% and 70.08% respectively) . The total coincidence rate (90.90%, 94.55%, respectively) and specificity (75.00% and 75.00% respectively) showed no significant difference (P> 0.05). Conclusion WB-DWI and PET / CT have some feasibility in the diagnosis of lymph node metastasis of gastric cancer. However, the cost of PET / CT detection is higher and the radiation is better. However, the cost of WB-DWI is lower and the radiation is smaller. Situation selection.