PET-CT和MRI诊断直肠癌区域淋巴结转移的价值分析  

Value of PET-CT and MRI in the Diagnosis of Regional Lymph Node Metastasis of Rectal Cancer

作　　者：张莹 徐会[1] 周军[2] ZHANG Ying;XU Hui;ZHOU Jun(Department of Radiotherapy and Chemotherapy,Zhongnan Hospital,Wuhan University,Wuhan 430071,Hubei Province,China;不详)

机构地区：[1]湖北省武汉大学中南医院放化疗胃肠肿瘤科,湖北武汉430071 [2]湖北省武汉大学中南医院影像科,湖北武汉430071

出　　处：《中国CT和MRI杂志》2019年第12期103-106,共4页Chinese Journal of CT and MRI

摘　　要：目的分析直肠癌区域淋巴结转移使用PET-CT和MRI的诊断价值。方法选择我院2015年3月-2018年7月收治经手术病理结果证实直肠癌的42例患者为研究对象,且术前均进行PET-CT、MRI诊断。比较PET-CT诊断、MRI诊断、PET-CT和MRI融合诊断三种诊断方式的诊断结果与病理学结果的一致性。结果PET-CT检查转移淋巴结最大标准摄取值(SUVmax)明显高于非转移淋巴结(P<0.05);MRI检查表观弥散系数(ADC)明显低于非转移淋巴结(P<0.05);PET-CT和MRI融合图像检查转移淋巴结长径、短径、长短径之比均高于非转移淋巴结(P<0.05)。PET-CT诊断、MRI诊断、PET-CT和MRI融合图像诊断直肠癌N分期的灵敏度分比为66.67%、80.00%、86.67%,特异度分别为85.19%、74.07%、88.89%,准确率78.57%、76.19%、88.10%,且PET-CT诊断、MRI诊断与病理结果检查结果存在一致性(Kappa>0.4),而PET-CT和MRI融合图像诊断与病理结果检查结果一致性较好(Kappa>0.7)。结论PET-CT、MRI对直肠癌区淋巴结转移有一定诊断价值,且联合诊断能提高诊断准确性。Objective To analyze the diagnostic value of PET-CT and MRI in regional lymph node metastasis of rectal cancer.Methods 42 patients with rectal cancer confirmed by surgical pathology who were admitted to the hospital from March 2015 to July 2018 were enrolled as study objects.Before surgery,all underwent PET-CT and MRI.The consistency of diagnostic results between PET-CT,MRI,PET-CT combined with MRI and pathological diagnosis was compared.Results The SUVmax of metastatic lymph nodes was significantly higher than that of non-metastatic lymph nodes by PET-CT(P<0.05).The ADC value by MRI was significantly lower than that of non-metastatic lymph nodes(P<0.05).The long diameter,short diameter and ratio of long and short diameter of metastatic lymph nodes by PET-CT and MRI fusion images were higher than those in non-metastatic lymph nodes(P<0.05).The sensitivity,specificity and accuracy rates of PET-CT,MRI,PET-CT and MRI fusion imaging for diagnosis of rectal cancer in N stage were(66.67%,80.00%,86.67%,)(85.19%,74.07%,88.89%)and(78.57%,76.19%,88.10%),respectively.There was consistency between PET-CT diagnosis,MRI diagnosis and pathological results(Kappa>0.4),consistency between PET-CT,MRI fusion image diagnosis and pathological results was good(Kappa>0.7).Conclusion PET-CT and MRI have certain diagnostic value for lymph node metastasis in rectal cancer area,and combined diagnosis can improve the diagnostic accuracy.

关 键 词：PET-CT MRI 直肠癌 淋巴结转移 

分 类 号：R735.37[医药卫生—肿瘤] R445.2[医药卫生—临床医学]