本文選題：胃癌　切入點(diǎn)：磁共振彌散加權(quán)成像　出處：《山東中醫(yī)藥大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的研究磁共振彌散加權(quán)成像對(duì)胃癌淋巴結(jié)轉(zhuǎn)移的診斷價(jià)值，探討ADC值對(duì)胃癌轉(zhuǎn)移淋巴結(jié)與非轉(zhuǎn)移淋巴結(jié)鑒別的指導(dǎo)意義。 資料與方法回顧性分析經(jīng)手術(shù)病理證實(shí)的43例胃癌患者的臨床資料及術(shù)前MRI圖像，測量胃癌轉(zhuǎn)移與非轉(zhuǎn)移淋巴結(jié)的長徑、短徑、最小ADC值以及右腎門層面右側(cè)豎脊肌ADC值，計(jì)算相對(duì)ADC值（rADC），利用ROC曲線下面積評(píng)價(jià)上述各項(xiàng)指標(biāo)鑒別胃癌轉(zhuǎn)移與非轉(zhuǎn)移淋巴結(jié)的診斷效能。 結(jié)果轉(zhuǎn)移淋巴結(jié)短徑和長徑均大于非轉(zhuǎn)移淋巴結(jié)，且兩者差異具有統(tǒng)計(jì)學(xué)意義（P＜0.001；P＜0.001）；轉(zhuǎn)移淋巴結(jié)的最小ADC值和rADC值均低于非轉(zhuǎn)移淋巴結(jié)，且差異均具有統(tǒng)計(jì)學(xué)意義（P＜0.001；P＜0.001）；短徑、長徑、最小ADC值和rADC值對(duì)鑒別胃癌胃周轉(zhuǎn)移與非轉(zhuǎn)移淋巴結(jié)均有診斷意義（Az＞0.5），其中最小ADC值的診斷效能最高，選取最小ADC值閾值為0.878×103mm2/s時(shí)，其靈敏度和特異度分別為87.7%和77.4%。轉(zhuǎn)移和非轉(zhuǎn)移淋巴結(jié)各ADC值指標(biāo)與形態(tài)學(xué)參數(shù)均無顯著相關(guān)性（均為P＞0.05）。 結(jié)論ADC值能很好的鑒別胃癌轉(zhuǎn)移與非轉(zhuǎn)移淋巴結(jié)，以最小ADC值最為敏感，，其診斷效能優(yōu)于形態(tài)學(xué)指標(biāo)。
[Abstract]:Objective to study the diagnostic value of diffusion-weighted magnetic resonance imaging (DWI) in lymph node metastasis of gastric cancer and to explore the significance of ADC value in differentiating metastatic lymph nodes from non-metastatic lymph nodes. Materials and methods the clinical data and preoperative MRI images of 43 patients with gastric cancer confirmed by surgery and pathology were retrospectively analyzed. The long, short and minimal ADC values of metastatic and non-metastatic lymph nodes of gastric cancer were measured, and the ADC values of the right spinal vertical muscles on the right hilum were measured. The relative ADC value was calculated and the area under the ROC curve was used to evaluate the diagnostic efficacy of the above indexes in differentiating metastatic and non-metastatic lymph nodes from gastric cancer. Results the short diameter and long diameter of metastatic lymph nodes were larger than those of non-metastatic lymph nodes, and the difference between them was statistically significant (P < 0.001), the minimum ADC value and rADC value of metastatic lymph nodes were lower than those of non-metastatic lymph nodes, and the differences were statistically significant (P < 0.001), short diameter, long diameter, short diameter, long diameter, long diameter, short diameter and long diameter of metastatic lymph nodes were significantly lower than those of non-metastatic lymph nodes. The minimum ADC value and rADC value have diagnostic significance in differentiating gastric cancer from non-metastatic lymph nodes. The minimum ADC value has the highest diagnostic efficacy. When the minimum ADC threshold is 0.878 脳 10 ~ 3mm ~ 2 / s, there is no significant difference between the minimum ADC value and non-metastatic lymph node, and the minimum ADC value is 0.878 脳 10 ~ 3 mm ~ (2) / s. The sensitivity and specificity were 87.7% and 77.4, respectively. There was no significant correlation between the ADC values of metastatic and non-metastatic lymph nodes and morphological parameters (P > 0.05). Conclusion ADC value can distinguish metastatic and non-metastatic lymph nodes from gastric carcinoma, and the minimum ADC value is the most sensitive one, and its diagnostic efficacy is better than that of morphological index.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.2;R735.2

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本文編號(hào)：1574128