多模态MRI在宫颈癌盆腔良恶性淋巴结鉴别诊断的临床应用价值  

The clinical value of multimodality MRI in differential diagnosis of benign and malignant pelvic lymph nodes of cervical carcinoma

作　　者：邢彦粉 姚刚 梁志鹏 XING Yanfen;YAO Gang;LIANG Zhipeng(Department of Radiology,The Affiliated Sir Run Run Hospital of Nanjing Medical University,Nanjing 211100,China)

机构地区：[1]南京医科大学附属逸夫医院影像科,江苏南京211100

出　　处：《医学影像学杂志》2022年第8期1356-1360,1364,共6页Journal of Medical Imaging

摘　　要：目的探讨多模态MRI对宫颈癌盆腔良恶性淋巴结的诊断效能。方法选取经手术病理证实的宫颈癌伴淋巴结显示47例(563枚淋巴结)患者的影像资料进行回顾性分析,采用多模态方法,包含常规MRI、扩散加权成像(diffuseion weighted imaging,DWI)和动态增强MRI(dynamiccontrast enhanced MRI,DCE-MRI)。对各项指标的诊断效能进行统计学分析。结果良性505枚,恶性58枚,两者在长/短径、边界及信号特点差异有统计学意义(χ^(2)=139.053、16.617、81.605、36.471、469.177,P<0.05);根据DCE-MRI的曲线,良、恶性淋巴结TIC-A、B、C型分别占82.6%(417/505)、16.4%(83/505)、1.0%(5/505),5.2%(3/58)、22.4%(13/58)、72.4%(42/58),差异有统计学意义(χ^(2)=360.782,P<0.05)。良、恶性淋巴结ADCmin值分别为0.83±0.13×10^(-3) mm^(2)/s、0.67±0.17×10^(-3) mm^(2)/s,差异有统计学意义(t=8.583,P<0.05);根据DCE-MRI的定量参数,良性淋巴结K^(trans)、V_(e)值低,恶性淋巴结K^(trans)、V_(e)值高,二者差异有统计学意义(t=13.042、t=22.013,P<0.05);联合应用ADC和K^(trans)、V_(e)值,采用直线回归分析对宫颈癌盆腔良恶性淋巴结的诊断有较强相关性(F=5.291、11.468、7.315,P<0.05)。结论多模态MRI对宫颈癌盆腔良、恶性淋巴结的鉴别诊断具有较高的效能。Objective To evaluate the value of multimodality MRI in the diagnosis of benign and malignant pelvic lymph nodes of cervical carcinoma.Methods The conventional MRI,DWI(diffuseion weighted imaging,DWI)and DCE-MRI(dynamiccontrast enhanced MRI,DCE-MRI)multimodality imaging data of 47 patients(563 lymph nodes)with cervical cancer lymphadenopathy confirmed by surgery and pathology were analyzed retrospectively.Results There were 505 benign cases and 58 malignant cases.There were significant differences in size,boundary and signal(χ^(2)=139.053,16.617,81.605,36.471,469.177,P<0.05);benign and malignant lymph nodes in TIC-A,B,C in the curve type of DCE-MRI were 82.6%(417/505),16.4%(83/505),1.0%(5/505),5.2%(3/58),22.4%(13/58),72.4%(42/58),respectively,with statistically significant difference(χ^(2)=360.782,P<0.05).The ADCmin values of benign and malignant lymph nodes were 0.83±0.13×10^(-3) mm^(2)/s,0.67±0.17×10^(-3) mm^(2)/s respectively with statistically significant difference(t=8.583,P<0.05).In quantitative parameters of DCE-MRI,the K^(trans) and V_(e) values of benign lymph nodes were low,while,the K^(trans) and V_(e) values of malignant lymph nodes were high,with statistically significant difference(t=13.042,t=22.013,P<0.05);The combination of ADC,K^(trans),V_(e) values were highly correlated with imaging diagnosis of benign and malignant pelvic lymph nodes in cervical cancer by Linear regression analysis(F=5.291,11.468,7.315,P<0.05).Conclusion Multi-modality MRI has high efficacy in differentiating benign from malignant lymph nodes in pelvic cavity of cervical cancer.

关 键 词：宫颈癌 磁共振成像 多模态 盆腔淋巴结 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]