MR不同序列诊断鉴别子宫内膜癌盆腔淋巴结价值探讨

摘要

Objective To investigate the values of different MR sequences in the detection of pelvic lymph nodes of endometrial cancer.Methods The image data of 66 patients with endometrial cancer treated at our hospital were retrospectively analyzed.Resuits The diameter of lymph nodes detected by T2W1 and DWI sequences were significantly lower than T1 W1 sequence (P ＜ 0.05).There was no difference in the diameter of lymph nodes detected between T2W1 sequence and DWI sequence (P ＞ 0.05).There was no difference in positive predictive value ofpelvic lymph nodes of endometrial cancer detected by T1W1,T2W1 or DWI sequences (P＞ 0.05).However,the negative predictive value of pelvic lymph nodes of endometrial cancer and detection accuracy of T1W1 was significantly higher but the specificity was significantly lower than T2W1 or DWI sequences (P ＜ 0.05).When b =150 × 10-3mm2/s,800×10-3mm2/s or 1000×10-3mm2/s,ADC values of the metastatic lymph nodes were significantly higher than those of non metastatic lymph nodes of ADC value.Conclusion Compared to T1 W1 or T2W1 sequence,DWI sequence has higher accuracy while lower specificity in the detection of pelvic lymph nodes of endometrial cancer.It is of great value to identify the pelvic lymph nodes of endometrial carcinoma by using different sequences of MR.%目的 探讨MR不同序列对子宫内膜癌盆腔淋巴结的鉴别诊断价值.方法 回顾性分析我院收治的66例子宫内膜癌患者的医学影像资料.结果 使用T2W1序列和DWI序列对淋巴结进行检测的短径显著低于使用T1W1序列(P＜0.05);使用T2W1序列对淋巴结进行检测的短径和使用DWI序列检测的短径差异无统计学意义(P＞0.05).T1W1、T2W1及DWI序列对子宫内膜癌盆腔淋巴结的阳性预测值差异无统计学意义(P＞0.05);T1W1序列检测的阴性预测值及灵敏度显著高于T2W1和DWI序列,特异度显著低于T2W1和DWI序列;T2W1序列检测的特异性显著低于DWI序列(P＜0.05).转移性淋巴结在1000×10-3、800×10-3及150× 10-3 mm2/s这三个b值时的ADC值显著高于非转移性淋巴结(P＜0.05).结论 DWI检测子宫内膜癌盆腔淋巴结的准确性高于T1W1和T2W1序列但特异度要低于T1W1和T2W1序列.综合使用MR不同序列诊断鉴别子宫内膜癌盆腔淋巴结具有重要价值.