表观扩散系数对宫颈恶性肿瘤盆腔淋巴结转移的诊断价值

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摘要目的：探讨表观扩散系数（ADC）对宫颈恶性肿瘤盆腔淋巴结转移的临床诊断价值。方法：选取2015年8月至2017年5月温州医科大学附属第一医院诊治的36例宫颈恶性肿瘤患者，术前均行3.0T MRI检查，术后均经病理检查证实。共收集宫颈恶性肿瘤盆腔淋巴结169枚，其中转移组淋巴结70枚，非转移组淋巴结99枚。采用Wilcoxon秩和检验分析转移组与非转移组淋巴结的ADC集各值、长径、短径、短/长径比及单个淋巴结体积之间的差异。结果：转移组和非转移组淋巴结ADC集各值（ADC5%-95%）差异无统计学意义（P＞0.05）；转移组淋巴结最短径和最长径均较非转移组大，转移组淋巴结体积亦明显大于非转移组，组间差异有统计学意义（Z=-7.94、-7.76、-6.82，P＜0.001）；转移组淋巴结短/长径比较非转移组小，差异有统计学意义（Z=-1.12，P＜0.001）。结论：ADC集各值对宫颈恶性肿瘤盆腔转移淋巴结的诊断价值并不大，但是结合DWI及T2WI图像测量淋巴结大小及体积，可以提高转移淋巴结诊断的准确性。

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关键词 ：宫颈肿瘤, 淋巴转移, 磁共振成像, 表观扩散系数

Abstract：Objective: To study the diagnostic value of apparent diffusion coefficient in pelvic lymph nodes metastasis of cervical cancer. Methods: Thirty-six patients of cancer patients were selected from August 2015 to May 2017, who were examined with preoperative 3.0T MRI in the First Affiliated Hospital of Wenzhou Medical University. Total 169 cervical cancer pelvic lymph nodes were collected, of which 70 metastatic lymph nodes (metastatic group) and 99 non-metastatic lymph nodes (non-metastatic group). The difference of the ADC values, the longest diameter, the shortest diameter, the volume of lymph nodes and the short/long ratio of metastatic lymph nodes and non-metastatic lymph nodes were analyzed using Wilcoxon test. Results: There was no significant difference of ADC values of lymph node between metastatic group and non-metastatic group (P>0.05). The longest diameter, the shortest diameter, the volume of metastatic group were longer than non-metastatic group (Z=-7.94, -7.76, -6.82, P<0.001), and the short/long ratio of metastatic group was smaller than non-metastatic group (Z=-1.12, P<0.001). Conclusion: The ADC diagnostic value on the pelvic lymph nodes metastatic of cervical cancer is not significant. However, combined with DWI and T2WI images to measure the size of lymph nodes can improve the diagnostic accuracy of metastatic lymph nodes.

Key words： uterine cervical neoplasms lymphatic metastasis magnetic resonance imaging apparent diffusion coefficient

收稿日期: 2017-06-10

基金资助:温州市科技局公益类项目（2016Y0353）

通讯作者: 叶琼，副研究员，Email：94301699@qq.com

作者简介: 董乐丹（1984-），女，浙江温州人，住院医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2017/V47/I11/815

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