螺旋CT多平面重建技术对胸段食管癌喉返神经旁淋巴结转移的诊断价值  

Diagnostic value of recurrent laryngeal nerve lymph node metastasis by multiplanar reconstruction of spiral CT in thoracic esophageal carcinoma

作　　者：刘玉 邹志强 辛宁 李传海 张梅 LIU Yu;ZOU Zhiqiang;XIN Ning;LI Chuanhai;ZHANG Mei(Department of Thoracic Surgery,The 960th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Jinan,250031,P.R.China)

机构地区：[1]中国人民解放军联勤保障部队第九六〇医院胸外科,济南250031

出　　处：《中国胸心血管外科临床杂志》2020年第10期1177-1181,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：解放军第九六〇医院院长基金(2019017)。

摘　　要：目的探讨螺旋CT多平面重建技术对胸段食管癌喉返神经旁淋巴结转移状态的诊断价值及最佳诊断标准。方法对我院2016年12月至2019年6月138例胸段食管癌患者的多层螺旋CT扫描数据应用多平面重建技术进行图像后处理,其中男113例、女25例,平均年龄47~85(63.03±15.58)岁。分别测量双侧喉返神经旁淋巴结的短径、长径,并计算短径/长径比。分别将上述3个参数与术后病理结果对照,绘制其各自的受试者工作特征(ROC)曲线。结果138例患者中左侧喉返神经旁淋巴结清扫291枚,平均每例清扫0~14(2.11±0.41)枚,转移率16.70%;右侧喉返神经旁淋巴结清扫436枚,平均每例清扫0~17(3.16±0.45)枚,转移率21.00%;总转移率29.70%。以左侧喉返神经旁淋巴结短径、长径及短径/长径比为淋巴结转移诊断标准,计算出的ROC曲线下面积分别为0.808、0.779、0.621。以右侧喉返神经旁淋巴结短径、长径及短径/长径比为淋巴结转移诊断标准,计算出的ROC曲线下面积分别为0.865、0.807、0.637。结论胸段食管癌喉返神经旁淋巴结转移率高,淋巴结短径对判断左、右侧喉返神经旁淋巴结转移状态具有更高的诊断效能。Objective To investigate the diagnostic value and the best criteria of multiplanar reconstruction(MPR)of spiral CT in recurrent laryngeal nerve lymph node metastasis.Methods We performed multiplanar reconstruction of the spiral CT data of 138 esophageal carcinoma patients admitted to our hospital between December 2016 and June 2019,including 113 males and 25 females with an average age of 47-85(63.03±15.58)years.The short and long diameters of recurrent laryngeal nerve lymph nodes were measured respectively,and then ratio of short to long diameter was calculated.The three parameters were contrasted with the pathological results and the receiver operating characteristic(ROC)curves for the parameters were drawn.Results Of the 138 patients,291 left recurrent laryngeal nerve lymph nodes were dissected with an average number of 0-14(2.11±0.41)per patient and the metastasis rate was 16.70%;while 436 right ones were dissected with the average number of 0-17(3.16±0.45)per patient and the metastasis rate was 21.00%.The total metastasis rate was 29.70%.In the diagnosis of lymph node metastasis,the areas under ROC curve for short and long diameters as well as the ratio of short to long diameter of left recurrent laryngeal nerve lymph nodes were 0.808,0.779,0.621,respectively,while those for the right ones were 0.865,0.807,0.637,respectively.Conclusion The metastasis rate of recurrent laryngeal nerve lymph nodes is high and the short diameter has a higher diagnostic value for recurrent laryngeal nerve lymph node metastasis.

关 键 词：食管癌 多平面重建技术 喉返神经 淋巴结转移 诊断 

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