摘要
目的探讨动态对比增强磁共振成像(DCE-MRI)对肺癌纵隔淋巴结转移的诊断价值。方法收集2019年1月—2020年6月经手术病理证实的32例肺癌患者资料(其中21枚转移性淋巴结,95枚非转移性淋巴结),全部均行DCE-MRI检查。测量纵隔淋巴结的DCE-MRI定量参数容积转运常数(K^(trans))、速率常数(K_(ep))、血管外细胞外容积分数(V_(e))。比较转移性淋巴结与非转移性淋巴结的DCE-MRI定量参数值的差异,评价各定量参数值对纵隔淋巴结转移的诊断效能。结果转移性淋巴结的K^(trans)、V_(e)值均高于非转移性淋巴结,差异具有统计学意义(P<0.05)。以病理结果为金标准绘制K^(trans)、K_(ep)、V_(e)的ROC曲线,曲线下面积分别为0.764、0.549、0.816,可知定量参数K^(trans)、V_(e)曲线下面积在0.7以上,具有一定的诊断效能,找出最佳诊断界值分别为0.117 min^(-1)和0.074,K^(trans)的敏感性和特异性为87.37%和66.67%,V_(e)的敏感性和特异性为75.79%和90.48%。结论(DCE-MRI)K^(trans)、V_(e)定量参数可以鉴别肺癌纵隔淋巴结是否转移,具有一定的诊断效能,可为指导临床制定个体化治疗方案提供更多有用的信息。
Objective The aim of this study was to investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis of mediastinal lymph node metastasis of lung cancer.Methods Thirty-two patients with lung cancer who underwent DCE-MRI before surgery from January 2019 to June 2020 were collected.A total of 116 mediastinal lymph nodes confirmed by surgery and pathology were removed,including 21 metastatic lymph nodes and 95 non-metastatic lymph nodes.The DCE-MRI quantitative parameters of mediastinal lymph nodes were followingvolume transfer constant(K^(trans)),rate constant(K_(ep)),and extravascular extracellular volume fraction(V_(e)).The differences between the DCE-MRI quantitative parameter values of the metastatic lymph nodes and non-metastatic lymph nodes were compared.The diagnostic efficiency of each quantitative parameter value for mediastinal lymph node metastasis was evaluated.Results The K^(trans)and V_(e)values of metastatic lymph nodes were higher than those of non-metastatic lymph nodes,the difference was statistically significant(P<0.05).The ROC curves of K^(trans),K_(ep)and V_(e)with pathological results were used as the gold standard,showing that the areas under the curve were 0.764,0.549,and 0.816,respectively.The areas under the curve of K^(trans)and V_(e)were all over 0.7,which has a certain diagnostic power,and the best diagnostic cut-off values were 0.117 min^(-1)and 0.074,respectively.The sensitivity and specificity of K^(trans)were 87.37%and 66.67%,respectively,and the sensitivity and specificity of V_(e)were 75.79%and 90.48%,respectively.Conclusion The quantitative parameters of K^(trans)and V_(e)(DCE-MRI)can distinguish whether the mediastinal lymph nodes of lung cancer have metastasis,and have a certain diagnostic efficiency,which can provide more useful information for guiding the clinical development of individualized treatment plans.
作者
焦志云
杜芳
何玲
袁保锋
JIAO Zhiyun;DU Fang;HE Ling;YUAN Baofeng(The Center of Medical Imaging,The Affiliated Hospital of Yangzhou University,Yangzhou 225000,China)
出处
《实用肿瘤学杂志》
CAS
2021年第2期142-147,共6页
Practical Oncology Journal
关键词
肺癌
磁共振成像
动态增强
淋巴结
Lung cancer
Magnetic resonance imaging
Dynamic enhancement
Lymph nodes
