多层螺旋CT多平面重建对径线较小的食管癌淋巴结转移的诊断价值  

The significance of MSCT multi-planar reconstruction in the diagnosis for minor lymph node metastasis(short-axis diameter<8mm) of esophageal cancer

作　　者：邵华飞[1] 屈东[1] 王铸[1] 

机构地区：[1]北京协和医学院 中国医学科学院肿瘤医院影像诊断科,北京100021

出　　处：《癌症进展》2014年第2期179-183,共5页Oncology Progress

摘　　要：目的探讨多层螺旋CT多平面重建(multi-planar reconstruction,MPR)对食管癌短径<8 mm的转移淋巴结术前诊断的意义。方法回顾分析经手术病理证实的104例食管癌淋巴结术前多层螺旋CT多平面重建的影像特征。结果对食管癌短径<8 mm的淋巴结,以"长径≤11.1 mm"为诊断标准时,敏感度及特异度分别为90.8%、36.3%;以"横纵比≥0.65"为诊断标准时,敏感度及特异度分别为77.6%、80.1%;以"强化程度(淋巴结CT值/同层肌肉CT值)≥0.95"为诊断标准时,敏感度及特异度分别为30.3%、73.3%;以"淋巴结边缘有无模糊"为诊断转移的标准时,敏感度和特异度分别为7.9%和75.5%。结论食管癌短径<8 mm的淋巴结中仍然存在很多转移淋巴结,采用"横纵比≥0.65"作为二次判断淋巴结转移的诊断标准,并辅助以长径、边缘有无模糊综合判断,有助于提高CT诊断淋巴结转移的准确率。Objective To explore the diagnosis value of MSCT multi-planar reconstruction （MPR） in lymph node （LN） me- tastasis with short diameter 〈 8 mm of esophageal cancer. Method The MSCT MPR in 104 eases of esophageal cancer that were confirmed pathologically were characterized retrospectively. Result For LN metastasis with short diameter 〈 8 nan, the sensitivity and specificity were 90. 8% and 36. 3% when positive predicts being ＂long diameter ≤11. 1 mm＂, and were 77. 6% and 80. 1% in terms of ＂LN with aspect ratio （short diameter/major diameter） ≥ 0. 65＂, then decreased to be 30. 3% and 73. 3% with ＂enhance- ment degree [LN CI＂ value / muscle CT value （same planar） ]≥0. 95＂, and were only 7. 9% and 75. 5% based on ＂LN metastasis with obscure rim＂, respectively. Conclusion In the diagnosis of LN metastasis with short diameter 〈 8 mm, ＂LN with aspect ratio ≥ 0. 65＂ is considerable as secondary positive predicts, and the ＂long diameter＂ and ＂obscure rim＂ might help improve accuracy.

关 键 词：CT 食管癌 淋巴结转移 

分 类 号：R735.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]