^(18)F-FDG PET/CT联合MRI评估直肠癌侧方淋巴结转移的应用研究  

Application of ^(18)F-FDG PET/CT Combined with MRI for the Evaluation of Lateral Lymph Node Metastasis in Rectal Cancer

作　　者：王铮[1] 肖国有[1] 赖少侣[1] 金观桥[1] 谢东[1] 李丽娅 田连芬 梁彬玲 周传集 韦红娇 柴华[1] 杨志[1] WANG Zheng;XIAO Guoyou;LAI Shaolv;JIN Guanqiao;XIE Dong;LI Liya;TIAN Lianfen;LIANG Binling;ZHOU Chuanji;WEI Hongjiao;CHAI Hua;YANG Zhi(Department of Medical Imaging,Guangxi Medical University Affiliated Tumor Hospital,Guangxi Clinical Medical Research Center of Imaging Medicine,Guangxi Key Clinical Specialty(Department of Medical Imaging),Advantage Cultivation Discipline(Department of Medical Imaging),Nanning Guangxi 530021,China)

机构地区：[1]广西医科大学附属肿瘤医院医学影像中心,广西影像医学临床医学研究中心广西临床重点专科(医学影像科)优势培育学科(医学影像学科),广西南宁530021

出　　处：《中国医疗设备》2021年第7期89-92,109,共5页China Medical Devices

基　　金：国家自然基金地区科学基金项目(81760533);广西重点研发计划(桂科AB19110015);广西医疗卫生适宜技术开发与推广应用项目(S201633,S2020093);广西壮族自治区卫生健康委员会课题(Z20190559,Z20190595,Z20190632,Z20200403,Z20200445,Z20200545,Z20210418,Z20210127,Z20210836,Z20210418、Z20210127、Z20210836);广西医科大学青年基金课题(GXMUYSF201819);2020年度广西医科大学教育教学改革立项项目(重点项目2020XJGZ05,2020XJGB16,课堂改革2020XJGKT07)。

摘　　要：目的探讨^(18)F-FDG PET/CT联合MRI评估直肠癌侧方淋巴结转移的应用价值。方法回顾性分析51例直肠癌患者病理证实的转移性、非转移性淋巴结33、45枚,比较两组间短径、SUV_(max)、ADC值,探讨不同指标及指标组合的诊断价值。结果PET/CT、MRI测量转移性、非转移性淋巴结短径差异无统计学意义(P>0.05),分别以MRI短径≥6.75 mm、PET/CT短径≥5.05 mm为转移性淋巴结诊断标准,两者灵敏度、特异性、准确性差异不大(P>0.05);将PET/CT短径≥5.05 mm联合T2WI信号不均联合诊断,灵敏度、特异性、准确性明显提高(P<0.05);非转移性淋巴结、转移性淋巴结ADC值、SUV_(max)值差异无统计学意义(P>0.05)。分别以SUV_(max)≥1.45、ADC值≤1.049为转移性淋巴结诊断标准,两者灵敏度、特异性、准确性差异不大(P>0.05);而SUV_(max)≥1.45联合ADC值≤1.049×10^(-3) mm^(2)/s诊断转移性淋巴结灵敏度、特异性、准确性明显提高(P<0.05)。结论^(18)F-FDG PET/CT联合MRI多模态显像在直肠癌侧方淋巴结转移有较高的临床应用价值,为疗前分期提供更准确N分期信息。Objective To investigate the application value of 18F-FDG PET/CT combined with MRI to evaluate for the assessment of lateral lymph node metastasis in rectal cancer.Methods Retrospective analyzed 33 and 45 metastatic and non-metastatic lymph nodes confirmed by surgical pathology in 51 rectal cancer patients,compared to the short diameter,SUV_(max),and ADC values between the two groups,and explored the diagnostic value of different indexes and combinations indexes.Results There were no statistically significant differences in the measurement of metastatic and non-metastatic lymph node short diameters of PET/CT and MRI(P>0.05).MRI short diameter≥6.75 mm and PET/CT short diameter≥5.05 mm were the diagnostic criteria for metastatic lymph nodes,the difference in specificity and accuracy is not significant(P>0.05).Combined diagnosis of PET/CT short diameter≥5.05 mm combined with T2WI signal unevenness,its sensitivity,specificity and accuracy were significantly improved(P<0.05).The difference in ADC values and SUV_(max) values of non-metastatic lymph nodes and metastatic lymph nodes were not statistically significant(P>0.05).SUV_(max)≥1.45 and ADC value≤1.049 were used as the diagnostic criteria for metastatic lymph nodes,respectively,while the sensitivity,specificity and accuracy of SUV_(max)≥1.45 combined with ADC value≤1.049×10^(-3) mm^(2)/s for the diagnosis of metastatic lymph nodes were significantly improved(P<0.05).Conclusion 18F-FDG PET/CT combined with MRI multi-modality imaging has high clinical application value in lateral lymph node metastasis of rectal cancer,and provides more accurate N staging information for pre-treatment staging.

关 键 词：直肠肿瘤 淋巴结转移 正电子发射断层显像术 磁共振 脱氧葡萄糖 

分 类 号：R817[医药卫生—影像医学与核医学]