ADC值鉴别胃癌淋巴结性质的研究  

Evaluation of ADC value on lymph nodes in patients with gastric carcinoma

作　　者：孟祥福 石洁 康静霞[3] 

机构地区：[1]山东省临沂市中医院放射科,山东临沂276000 [2]河北省邯郸市第一人民医院CT室 [3]山东省临沂市人民医院放射科

出　　处：《实用放射学杂志》2014年第9期1493-1497,共5页Journal of Practical Radiology

摘　　要：目的 探讨ADC值鉴别胃癌转移与非转移淋巴结的价值.方法 回顾性分析经手术病理证实的43例胃癌患者的临床资料及术前MRI图像,测量胃癌转移与非转移淋巴结的长径、短径、最小ADC值以及右肾门层面右侧竖脊肌ADC值,计算相对ADC值（rADC）,利用ROC曲线下面积评价上述各项指标鉴别胃癌转移与非转移淋巴结的诊断效能.结果 转移淋巴结短径和长径均大于非转移淋巴结,且两者差异具有统计学意义（P＜0.001;P＜0.001）;转移淋巴结的最小ADC值和rADC值均低于非转移淋巴结,且差异均具有统计学意义（P＜0.001;P＜0.001）;短径、长径、最小ADC值和rADC值对鉴别胃癌胃周转移与非转移淋巴结均有诊断意义（Az＞0.5）,其中最小ADC值的诊断效能最高,选取最小ADC值阈值为0.913×10^-3mm2/s时,其灵敏度和特异度分别为87.7％和77.4％.转移和非转移淋巴结各ADC值指标与形态学参数均无显著相关性（均为P＞0.05）.结论 ADC值能很好地鉴别胃癌转移与非转移淋巴结,以最小ADC值最为敏感,其诊断效能优于形态学指标.Objective To determine the diagnostic value of ADC in the differentiation of metastatic lymph nodes （LNs） from nora metastatic LNs. in gastric carcinoma. Methods Magnetic resonance imaging （MR1） scans before surgery and clinical data of 43 pathologically proven gastric carcinoma were retrospectively reviewed. Size-based criteria （i. e. short-axis diameter and long-axis di- ameter）, minimum ADC values were measured in metastatic and non-metastatic LNs. Relative ADC （rADC） was calculated by ADC lesion/ADC reference site, and the right erector spinae was determined to be the reference site for rADC. A receiver operating char- acteristic （ROC） curve was generated to evaluate the capability of morphological and ADC measurements in distinguishing metastatic LNs. Results The short-axis and long-axis diameter of metastatic LNs were larger than that of non-metastatic LNs, and differences showed statistic significance （P= 0. 000, P= 0. 000）. The minimum ADC value and rADC of metastatic I.Ns were significantly low- er than that of non-metastatic LNs （P=0.000, P=0.000）. The short-axis diameter, long-axis diameter, minimum ADC value and rADC were contributory to differentiate metastatic from non-metastatic I.Ns. The area under the ROC curve of minimum ADC was greater than that of other criteria. Using the minimum ADC criteria （≤0. 913×10mm-3/s）, the sensitivity and specificity for dif- ferentiating metastatic from non-metastatic LNs were 87.75% and 77. ,1%, respectively. The correlations between ADC-based criteria and size-based criteria both in metastatic and non-metastatic LNs were found to be insignificant （P〉0. 05）. Conclusion ADC value has a high diagnostic efficacy in differentiating metaslatic LNs in patient with gastric carcinoma, and minimum ADC shows a superi- or diagnostic performance.

关 键 词：胃癌 扩散加权成像 表观扩散系数 淋巴结 

分 类 号：R735.2[医药卫生—肿瘤] R445.2[医药卫生—临床医学]