胃癌转移性淋巴结CT特征分析  

CT characteristics of metastatic lymph node of gastric cancer

作　　者：高知玲[1] 陈勇[1] 赵丹[1] 来彦博[1] 李梦迪[1] 殷鑫[1] 吴杰[1] 郭玉林[1] 

机构地区：[1]宁夏医科大学总医院放射科,宁夏银川750004

出　　处：《实用放射学杂志》2014年第1期69-73,115,共6页Journal of Practical Radiology

基　　金：宁夏回族自治区自然基金资助项目（NZ09123）.

摘　　要：目的探讨胃癌转移性淋巴结相关CT特征。方法采用影像工作站电影回放方式对所有患者淋巴结影像特征（形态、大小、密度及强化程度等）盲法阅片。统计方法选用x2检验、Mann-Whitney非参数秩和检验、多因素利用Logistic回归分析以及绘制接受者工作特征（ROC）曲线分析。结果MIX2T检出245个阳性淋巴结的短径范围为2．10-31．9mm，均值为（5．87±3．25）mm，长径范围2．20-42．10mm，均值为（7．73±4．87）mm；327个阴性淋巴结的短径范围为2．10～11．00mm，均值为（3．83±1．43）mm，长径范围2．30-29．00mm，均值为（4．96±2．33）mm，2组间的差异有统计学意义（P〈O．05）。245个阳性淋巴结平扫、动脉期、门脉期及平衡期CT值均值（HU）分别为：8．69±21．16、46．63±25．14、54．49±23．67、47．46±20．61；327个阴性淋巴结相应CT值的均值（Hu）分别为：-O．10±19．60、33．45±21．91、41．70120．73、36．45±18．31，在门脉期及平衡期2组间的差异有统计学意义（P〈O．05）。结论胃癌淋巴结形态、大小、密度及强化程度是判断胃癌淋巴结转移性的重要指标。Objective To investigate the characteristics of the lymph node metastasis on MDCT images in patients with gastric carcinoma. Methods Preoperative CT examinations were retrospectively analyzed in 71 patients with gastric carcinoma after D2 or D3 radical resection. The diagnosis of lymph node metastasis of gastric carcinoma were based on pathological examinations of excised specimens. Imaging were reviewed by two radiologists blindly using MDCT cine workstation. The relationships between lymph node metastases and MDCT findings were analyzed statistically by SPSS using Mann-Whitney test, Zz test, logistic regression analysis. Results A total of 245 metastasi^positive lymph nodes were detected with short diameter ranged from 2. 10 to 31.9 mm（mean , 5. 87 mm± 3.25 mm） and the long diameter ranged from 2.20 to 42.10 mm （mean,7.73 mm±4.87 mm）. The 327 metastasis-negative lymph nodes were detected with the short diameter ranged from 2.10 to 11.00 ram（mean, 3.83 mm±1. 43 mm） and the long diameter ranged from 2.30 to 29.00 mm （mean, 4.96 mm±2.33 mm）. There are significant differences of diameters{short or long） between metastasis-positive and metastasis-negative lymph nodes （P〈0.05）. The mean attenuation values of 245 metastasis-positive lymph nodes in non-enhanced, arterial phase, portal vein phase, venous phase were （8. 69＋_21.16）HU, （46. 63±25.14）HU, （54. 49±23. 67） HU, （47.46 ±20.61） HU. The mean of attenuation values of 327 metastasis-negative lymph nodes in homologous phase were （-0.10 ± 19.60） HU , （33.45±21.91） HU , （41.70±20.73） HU , （36. 45±18. 31） HU. There are significant differences of attenuation values （in portal vein or venous phase） between metastasis-positive and metastasis-negative lymph nodes （P〈 0.05）. Conclusion The sharp, size, density and enhanced degree of lymph node of gastric carcinoma displayed on MDCT are important criteria for the evaluation of lymph node metastasis in gastric cancer.

关 键 词：胃癌 淋巴结转移 计算机体层成像 

分 类 号：R735.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]