本文選題：結(jié)直腸腫瘤　切入點(diǎn)：淋巴轉(zhuǎn)移　出處：《中國(guó)醫(yī)學(xué)影像學(xué)雜志》2015年07期

【摘要】：目的擴(kuò)散加權(quán)成像(DWI)能顯著提高對(duì)未出現(xiàn)體積增大的轉(zhuǎn)移淋巴結(jié)的診斷能力,本研究旨在評(píng)估結(jié)直腸癌區(qū)域淋巴結(jié)轉(zhuǎn)移DWI表現(xiàn)是否有助于評(píng)估患者的預(yù)后,并分析與預(yù)后有關(guān)的因素。資料與方法 47例結(jié)直腸癌患者行DWI檢查后均行手術(shù)治療,對(duì)照術(shù)后病理結(jié)果,確定區(qū)域轉(zhuǎn)移性(DWI陽(yáng)性)和非轉(zhuǎn)移性(DWI陰性)淋巴結(jié)。比較DWI陽(yáng)性和陰性患者5年無(wú)病生存率和整體生存率。評(píng)估患者各相關(guān)因素與預(yù)后的相關(guān)性,相關(guān)因素包括有無(wú)DWI診斷區(qū)域淋巴結(jié)轉(zhuǎn)移(DWI陽(yáng)性淋巴結(jié))、DWI陽(yáng)性最大淋巴結(jié)的短軸直徑和長(zhǎng)軸直徑、DWI陽(yáng)性淋巴結(jié)的數(shù)量。結(jié)果 47例患者中,DWI診斷區(qū)域淋巴結(jié)轉(zhuǎn)移10例(21%),DWI陽(yáng)性表現(xiàn)為淋巴結(jié)受侵犯,呈高信號(hào)。DWI陰性患者5年無(wú)病生存率和整體生存率明顯高于DWI陽(yáng)性患者(P0.05)。最大轉(zhuǎn)移淋巴結(jié)的短軸直徑與發(fā)生遠(yuǎn)處轉(zhuǎn)移有相關(guān)性(AUC=0.77,P0.05),最高準(zhǔn)確率為76%時(shí)的短軸直徑為9 mm。最大轉(zhuǎn)移淋巴結(jié)的短軸直徑、長(zhǎng)軸直徑與整體生存率有相關(guān)性(AUC=0.84、0.75,P0.05),最高準(zhǔn)確率為85%時(shí)的短軸直徑為9 mm,最高準(zhǔn)確率為76%時(shí)的長(zhǎng)軸直徑為11mm。DWI陽(yáng)性最大淋巴結(jié)短軸直徑≤9 mm患者的5年無(wú)病生存率和整體生存率高于短軸直徑9 mm患者(P0.05);長(zhǎng)軸直徑≤11 mm患者的5年無(wú)病生存率和整體生存率高于長(zhǎng)軸直徑11 mm患者(P0.05)。全部DWI陽(yáng)性淋巴結(jié)均被切除的患者5年無(wú)病生存率高于DWI陽(yáng)性淋巴結(jié)未被完全切除的患者(P0.05)。結(jié)論 DWI陰性的患者預(yù)后更好;在DWI陽(yáng)性患者中,轉(zhuǎn)移淋巴結(jié)較小的患者預(yù)后更好。
[Abstract]:Objective Diffusion-weighted imaging (DWI) can significantly improve the diagnostic ability of metastatic lymph nodes without volume increase. The purpose of this study was to evaluate whether DWI findings of regional lymph node metastasis in colorectal cancer can help to evaluate the prognosis of patients. Data and methods 47 patients with colorectal cancer were treated by DWI and compared with the pathological results. DWI positive and non-metastatic DWI negative lymph nodes were determined. The 5-year disease-free survival rate and overall survival rate of DWI positive and negative patients were compared, and the correlation between the relevant factors and prognosis was evaluated. The related factors included the number of DWI positive lymph nodes with short axis diameters and long axis diameters with or without DWI diagnosis of regional lymph node metastasis. Results in 47 patients, regional lymph node metastasis was diagnosed by DWI. In 10 cases, lymph node involvement was found on DWI. The 5-year disease-free survival rate and overall survival rate in patients with hyperintense. DWI negative were significantly higher than those in DWI positive patients (P 0.05). There was a correlation between the short axis diameter of the largest metastatic lymph nodes and distant metastasis. 9 mm. short axis diameter of the largest metastatic lymph node, The long axis diameter was correlated with the overall survival rate. The highest accuracy rate was 9 mm in the short axis diameter at 85 and the long axis diameter in the 11mm.DWI positive lymph node was 鈮，

本文編號(hào)：1657005