本文選題：胃腫瘤 + 淋巴結(jié)轉(zhuǎn)移�。� 參考：《南京大學(xué)》2014年碩士論文

【摘要】：目的：探討術(shù)前磁共振彌散加權(quán)成像(DWI)對(duì)胃癌淋巴結(jié)轉(zhuǎn)移的診斷價(jià)值。方法：對(duì)2011年12月至2012年12月間南京大學(xué)醫(yī)學(xué)院附屬鼓樓醫(yī)院收治52例胃癌患者進(jìn)行磁共振DWI檢查,對(duì)應(yīng)術(shù)中標(biāo)記的淋巴結(jié),分別測(cè)量淋巴結(jié)的ADC值及短徑,并與術(shù)后病理結(jié)果相對(duì)照。采用受試者工作特征曲線(ROC)評(píng)價(jià)ADC值及短徑對(duì)胃癌淋巴結(jié)轉(zhuǎn)移的診斷價(jià)值。結(jié)果：DWI檢測(cè)到轉(zhuǎn)移性淋巴結(jié)180枚,非轉(zhuǎn)移性淋巴結(jié)57枚,均為高信號(hào)。DWI上轉(zhuǎn)移性淋巴結(jié)ADC值明顯低于非轉(zhuǎn)移性淋巴結(jié)[(1.059±0.196)比(1.402±0.285)×10-3mm2/s,P0.001]；以1.189×10-3mm2/s作為ADC值評(píng)估轉(zhuǎn)移性淋巴結(jié)的最佳閾值,其敏感度、特異度和曲線下面積(AUC)分別為78.9%、72.8%和0.840,其對(duì)術(shù)前N分期診斷的總體準(zhǔn)確率為80.8%(42/52)。DWI上轉(zhuǎn)移性淋巴結(jié)短徑明顯長(zhǎng)于非轉(zhuǎn)移性淋巴結(jié)[(8.08±3.99)比(6.75±2.70)mm,P=0.005]；以5.05 mm作為淋巴結(jié)短徑評(píng)估轉(zhuǎn)移性淋巴結(jié)的最佳閾值時(shí),其敏感度、特異度和AUC分別為88.3%、29.8%和0.602,其對(duì)術(shù)前N分期診斷的總體準(zhǔn)確率為59.6%(31/52)。結(jié)論：磁共振DWI對(duì)胃癌淋巴結(jié)轉(zhuǎn)移具有較高的診斷價(jià)值,以ADC值及淋巴結(jié)短徑作為診斷標(biāo)準(zhǔn)可用于術(shù)前N分期的診斷。
[Abstract]:Objective: to evaluate the diagnostic value of preoperative diffusion weighted Mr imaging (DWI) in lymph node metastasis of gastric cancer. Methods: from December 2011 to December 2012, 52 patients with gastric cancer treated in Gulou Hospital affiliated to Medical College of Nanjing University were examined by DWI. The ADC values and short diameter of lymph nodes were measured respectively. And compared with postoperative pathological results. The value of ADC and short diameter in the diagnosis of lymph node metastasis of gastric cancer was evaluated by means of operating characteristic curve (ROC). Results 180 metastatic lymph nodes and 57 non-metastatic lymph nodes were detected on DWI. The ADC values of metastatic lymph nodes on DWI were significantly lower than those on non-metastatic lymph nodes [1.059 鹵0.196] 脳 10 ~ (-3) mm ~ (-2) 路s ~ (-1) P ~ (0.001). 1.189 脳 10-3mm2/s was used as the best threshold for evaluating metastatic lymph nodes. Its sensitivity, The specificity and area under the curve were 72.8% and 0.840%, respectively. The overall diagnostic accuracy of N staging was 80.842%. DWI was significantly longer than that of non-metastatic lymph nodes [8.08 鹵3.99] vs 6.75 鹵2.70 mm P0.005. When the optimal threshold for sexual lymph nodes, The sensitivity, specificity and AUC were 88.329.8% and 0.602, respectively. Conclusion: DWI has a high diagnostic value for lymph node metastasis of gastric cancer. ADC value and short diameter of lymph node can be used as diagnostic criteria for preoperative N staging of gastric cancer.
【學(xué)位授予單位】：南京大學(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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