DWI联合高分辨T_(2)WI与CT成像在胸段食管癌术前分期中的应用分析  

A pplication of DWI Combined with High-resolution T_(2)WI and CT Imaging in Preoperative Staging of Thoracic Esophageal Carcinoma

作　　者：段东奎[1] 卢万里[1] 张耕瑞 王新[1] 杨丽[1] 张春敭[2] DUAN Dong-kui;LU Wan-li;ZHANG Geng-rui;WANG Xin;YANG Li;ZHANG Chun-yang(Department of Thoracic Surgery,Nanyang City Central Hospital,Nanyang473000,Henan Province,China;Department of Thoracic Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]南阳市中心医院胸外科,河南南阳473000 [2]郑州大学第一附属医院胸外科,河南郑州450052

出　　处：《中国CT和MRI杂志》2022年第12期95-97,共3页Chinese Journal of CT and MRI

基　　金：河南省医学攻关计划项目(2018020067);河南省高等学校重点科研项目计划(19A320053)。

摘　　要：目的研究磁共振弥散加权成像(DWI)联合高分辨T_(2)加权成像(T_(2)WI)与X线计算机断层扫描(CT)成像在胸段食管癌术前分期中的应用价值。方法回顾性分析本院2018年3月至2019年8月诊治的300例胸段食管癌患者临床资料,术前均接受磁共振成像(MRI)和CT检查。以术后病理学结果为“金标准”,比较影像学检查和病理TN分期的一致性和诊断效能、食管病变组织ADC值,并分析其影像学表现。结果相比于单纯CT检查,DWI联合高分辨T_(2)WI及CT与病理T分期诊断一致性更高,且T_(1)、T_(2)分期准确率明显更高(P<0.05);DWI联合高分辨T_(2)WI及CT诊断N分期的敏感度、特异度和准确率显著高于单纯CT检查(P<0.05);N1期患者平均ADC值和最小ADC值均显著高于N0期患者(P<0.05)。结论DWI联合高分辨T_(2)WI与CT成像可较为准确的对胸段食管癌进行术前诊断和TN分期,为治疗方案的制定提供重要依据。Objective To study the application value of magnetic resonance diffusion weighted imaging(DWI)combined with high-resolution T_(2)weighted imaging(T_(2)WI)and X-ray computed tomography(CT)imaging in preoperative staging of thoracic esophageal cancer.Methods The clinical data of 300 patients with thoracic esophageal carcinoma who were diagnosed and treated in the hospital from March 2018 to August 2019 were retrospectively analyzed.Before surgery,All patients completed magnetic resonance imaging(MRI)and CT examinations.The gold standard of diagnosis is the result of postoperative pathological examination,the consistency of imaging examinations and pathological TN staging,diagnostic efficiency and ADC value of diseased esophageal tissues were compared,and the imaging performance was analyzed.Results Compared with CT alone,DWI combined with high-resolution T_(2)WI and CT was more consistent with pathological T staging diagnosis,and the accuracy of T_(1)and T_(2)staging were significantly higher(P<0.05).The sensitivity,specificity and accuracy of DWI combined with high-resolution T_(2)WI and CT in diagnosis of N staging were significantly higher than those of CT alone(P<0.05).The average ADC value and minimum ADC value at N1 stage were significantly higher than those at N0 stage(P<0.05).Conclusion DWI combined with high-resolution T_(2)WI and CT can be used for accurate preoperative diagnose and TN staging of thoracic esophageal carcinoma,which provides an important basis for the development of treatment plan.

关 键 词：磁共振弥散加权成像 高分辨T2加权成像 X线计算机断层扫描 胸段食管癌 术前分期 

分 类 号：R445.2[医药卫生—影像医学与核医学]