MR与PET/CT对鼻咽癌咽后淋巴结转移诊断的对比研究  

The comparative analysis of MR and PET-CT detecting tetropharygeal lymph node metastasis in nasopharygeal carcinoma

作　　者：黄军荣[1,2] 张玉兰[1] 张纯[2,3] 陈昱明[2,3] 吴伟艺[2,3] 陈文尖[2,3] 赵艳海[2,3] 

机构地区：[1]广东省东莞市人民医院放射科,广东东莞523000 [2]广东省东莞市人民医院肿瘤中心,广东东莞523000 [3]广东省东莞市人民医院放疗科,广东东莞523000

出　　处：《医学影像学杂志》2013年第6期846-849,共4页Journal of Medical Imaging

摘　　要：目的以鼻咽癌2008分期为标准探讨MR与PET/CT对咽后淋巴结转移诊断的差异。方法收集经病理确诊并在治疗前间隔1周内同时行MR与PET/CT检查的80例鼻咽癌患者资料进行回顾分析:MR以2008分期为标准,咽后淋巴结最大横断面的最小径≥5mm为阳性;PET/CT检查如咽后淋巴结出现异常放射性浓聚,SUV≥2.5则定为阳性。由两位经验丰富的影像医师阅片,以统一意见评定,并对两种检查方法的诊断结果进行统计学分析。结果 80例鼻咽癌患者中MR检查发现咽后淋巴结转移的有42例(占52.50%),共69枚淋巴结;PET/CT诊断为阳性的33例(占41.25%),共53枚淋巴结,McNemar卡方检验P=0.049,P<0.05提示两种检查方法对鼻咽癌咽后淋巴结转移的诊断结果差异具有统计学意义,MR优于PET/CT;而Kappa检验两者的吻合系数k=0.579,0.7>k≥0.4提示两种检查方法对鼻咽癌咽后淋巴结转移诊断结果的吻合度一般。结论 MR对鼻咽癌咽后淋巴结转移的诊断在一定程度上优于PET/CT,以MR作为鼻咽癌咽后淋巴结转移和临床分期的首选检查手段是合理可行的。Objective To explore the differences in diagnosis of retropharyngeal lymph node metastasis of nasopharyngeal carcinoma between MR and PET/CT based on the Chinese 2008 staging system of nasopharyngeal carcinoma. Methods 80 cases of nasopharyngeal carcinoma patients with pathology confirmed were collected, MR and PET/CT were all performed within 1 week before treatment. The diagnostic criteria of retropharyngeal lymph node metastasis for MR： based on the Chinese 2008 staging system of nasopharyngeal carcinoma, the minimum diameter of single retropharyngeal lymph node of the largest cross-sectional was ≥ 5 mm, the diagnostic criteria of retropharyngeal lymph node metastasis for PET/ CT included abnormal accumulation of irradiation in the retropharyngeal lymph node with the standard uptake value（SUV） ≥2.5. Using the SPSS 13.0 software, diagnostic results of the two methods of statistical analysis were performed. Results Among the 80 patients with nasopharyngeal carcinoma, MR detected retropharyngeal lymph node metastasis in 42 cases, accounting for 52.50%, a total of 69 lymph nodes; PET/CT detected 33 cases of positive, accounting for 41.25%, a total of 53 lymph nodes, McNemar test, P =0. 049, suggesting that the two inspection methods had a statistically significant difference between diagnosis of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma. MR was su- perior to PET/CT. The Kappa test, k=0. 579, which showed that diagnosis of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma both MR and PET/CT, had moderate consistency. Conclusion MR in the diagnosis of retropharyngeal lymph node metastasis of nasopharyngeal carcinoma is better than that of PET/CT, MR as the preferred inspection means of retropharyngeal lymph node metastasis and clinical staging for nasopharyngeal carcinoma is reasonable and feasible.

关 键 词：鼻咽癌 咽后淋巴结 磁共振成像 正电子发射计算机体层摄影 

分 类 号：R739.6[医药卫生—肿瘤] R445.2[医药卫生—临床医学]