摘要
目的研究MR不同序列对子宫内膜癌盆腔淋巴结的检出和淋巴结转移的诊断效能。资料与方法49例患者的568组子宫内膜癌盆腔淋巴结获得病理诊断。对这49例患者的MR不同序列图像进行分析。对应获得病理的淋巴结分组,在T1WI、T2WI、DWI图像上记录是否检出淋巴结及其大小。以短径>1cm作为淋巴结转移标准诊断,计算各序列诊断的正确度、灵敏度、特异度、阳性预测值、阴性预测值,以及各序列对所有病理证实的淋巴结诊断的正确度、灵敏度、特异度、阳性预测值、阴性预测值。结果 DWI检出的淋巴结组数最多(33组),T2WI和DWI阳性淋巴结检出率最高,为87.5%。不同序列对已检出的淋巴结进行诊断评价,正确度最高的为DWI序列,为87.9%。T1WI的灵敏度和阳性预测值最高,分别为91.7%和91.7%;DWI的特异度和阴性预测值最高,分别为90%和90%。对于有病理结果的所有淋巴结,正确度最高的是T1WI和T2WI,均达98.9%,T2WI的灵敏度最高和阴性预测值最高,分别为75%和99.3%。T1WI的特异度和阳性预测值最高,分别为99.8%和91.7%。对于49例患者,常规T1WI及T2WI诊断的正确度最高,均为93.9%。结论利用短径诊断子宫内膜癌盆腔淋巴结转移的诊断效能较高。DWI增加对盆腔淋巴结的检出,但不能显著提高诊断的正确度。
Purpose To evaluate the emciency of different MR sequences in the detection of pelvic lymph node and diagnosis of pelvic lymph node metastasis in patients with endomelrial cancer. Materials and Methods Totally 568 groups of the pelvic lymph nodes （PLN） in 49 patients had been pathologically proved metastatic or non-metastatic, 16 groups of PLN metastasis in 6 patients were diagnosed. Imagings of different MR sequences of these 49 patients were analyzed. According to the lymph node groups achieved pathological results, all nodes were evaluated on T1WI, T2WI and DWI. The location as well as the length and width of the detected nodes were recorded. A node was assumed metastatic on MR imagings a soft-tissue slructure with its width greater than 1 cm. The diagnostic accuracy, sensitivity, specificity, positive and negative predictive values of each sequence and lymph nodes confu＇med by pathology were calculated. Results Thirty-three groups of PLN were clearly detected on DWI, while detection rate of the metastatic nodes was the highest with DWI and T2WI （78.5% and 78.5%, respectively）. The detected lymph nodes were evaluated by different sequences, results showed that DWI sequence presented the highest accuracy （87.9%）. T1WI presented the highest sensitivity and positive predictive value （91.7% and 91.7% respectively）; DWI presented the highest specificity and negative predictive value （90% and 90%） respectively. For lymph nodes confirmed by pathology, TIWI and T2WI presented the highest accuracy （98.9%,4 and 98.9% respectively）, T2WI presented the highest sensitivity and negative predictive value （75% and 99.3% respectively）. T IWI presented the highest specificity and positive predictive value （99.8% and 91.7% respectively）. For those 49 patients, DCE presented the highest specificity and negative predictive value （100% and 93.3% respectively）. Routine T1WI and T2WI showed the highest diagnostic accuracy （93.9% and 93.9% respectively）. Conclusion It has a high efficiency in diagnosing pelvic lymph node metastasis of endometrial cancer by the width of lymph nodes. DWI can improve the detection of pelvic lymph nodes, but can not significantly improve the diagnostic accuracy.
出处
《中国医学影像学杂志》
CSCD
北大核心
2011年第5期394-398,共5页
Chinese Journal of Medical Imaging
关键词
癌
子宫内膜样
淋巴转移
磁共振成像
Carcinoma, endometrioid
Lymphatic metastasis
Magnetic resonance imaging
作者简介
通讯作者 王霄英 E-mail：ejr．wangxiaoying@vip．163．com
