1.5T磁共振不同序列用于检出妇科肿瘤盆腔淋巴结转移的比较

目的:比较1.5T磁共振(MRI)不同序列条件下对妇科肿瘤盆腔淋巴结转移的检出情况,探讨最佳检出序列条件。方法:选取2015年5月-2017年5月初诊为卵巢癌、宫颈癌、子宫内膜癌的患者78例作为研究对象,均行盆腔淋巴结清扫术。所有患者术前均行T1加权序列(T1WI)、T2加权序列(T2WI)、增强扫描(T1WI+C)、弥散加权成像(DWI)检查,记录每个序列检查条件下检出的盆腔转移淋巴结个数及分布。以病理结果作为判断的"金标准"进行对比。结果:对比病理检查结果,应用DWI序列对妇科肿瘤盆腔淋巴结转移的检出率(95.8%)显著高于T2WI-MRI序列(85.8%)和T1WI-MRI序列(75.0%)(P0.05);DWI序列与T1WI+C序列(90.8%)相比差异无统计学意义(P0.05);DWI阈值法与DWI短径法相比,淋巴结的检出率差异无统计学意义(P0.05)。结论:应用1.5T磁共振检查妇科肿瘤盆腔淋巴节转移时,采用DWI序列扫描对于转移淋巴结的具有较高的检出率,显著优于其他序列扫描;在进行阳性淋巴结判断中,ADC阈值法和短径法均可选用。

Comparison of Different Scan Programs of 1.5T MRI for the Detection of Pelvic Lymph Node Metastasis in Gynecological Tumor

ABSTRACT Objective: To compare different sequences of 1.5T MRI for the detection of gynecological tumor pelvic lymph node metastasis, and discuss the optimal detection sequence. Methods: 78 cases of patients who were diagnosed with ovarian cancer, cervical cancer, endometrial cancer with pelvic lymph node metastasis in gynaecology of our hospital were selected from May 2015 to May 2017, they were performed the pelvic lymph node dissection. Before the operation, every patient was examined by conventional T1 weighted imaging (T1WI), T2 weighted imaging (T2WI), T1WI contrast ( T1WI + C), diffusion weighted imaging ( DWI ) scan program, and their lymphatic metastasis team location and number were recorded and summed. The positive ratios of lymphatic node at different scan pro- gram with the pathological results, and analyzed the two positive DWI criteria were compared. Results: Compared with the pathological report ( 50 teams 120 nodes), the number of pelvic lymphatic nodes showed the higher ratio at DWI program ( 50 teams 115 nodes) than T1WI-MRI (75.0%) and T2WI-MRI (85.8%), the positive ratio was 95.8%. But there was no significant difference between DWI se- quence and T1WI+C sequence (90.8%) (P>0.05), and the detection rate of lymph nodes showed no significant difference between the DWI threshold method and DWI short diameter method (P>0.05). Conclusion: DWI scan program was superior to conventional T1WI and T2WI scan at 1.5T MRT. As for positive ratio criteria, both short calibration criteria and apparent diffusion coefficient ( ADC) value criteria were reasonable.