本文選題：胃腫瘤 + 淋巴結轉移　； 參考：《南京大學》2014年碩士論文

【摘要】：目的：探討術前磁共振彌散加權成像(DWI)對胃癌淋巴結轉移的診斷價值。方法：對2011年12月至2012年12月間南京大學醫(yī)學院附屬鼓樓醫(yī)院收治52例胃癌患者進行磁共振DWI檢查,對應術中標記的淋巴結,分別測量淋巴結的ADC值及短徑,并與術后病理結果相對照。采用受試者工作特征曲線(ROC)評價ADC值及短徑對胃癌淋巴結轉移的診斷價值。結果：DWI檢測到轉移性淋巴結180枚,非轉移性淋巴結57枚,均為高信號。DWI上轉移性淋巴結ADC值明顯低于非轉移性淋巴結[(1.059±0.196)比(1.402±0.285)×10-3mm2/s,P0.001]；以1.189×10-3mm2/s作為ADC值評估轉移性淋巴結的最佳閾值,其敏感度、特異度和曲線下面積(AUC)分別為78.9%、72.8%和0.840,其對術前N分期診斷的總體準確率為80.8%(42/52)。DWI上轉移性淋巴結短徑明顯長于非轉移性淋巴結[(8.08±3.99)比(6.75±2.70)mm,P=0.005]；以5.05 mm作為淋巴結短徑評估轉移性淋巴結的最佳閾值時,其敏感度、特異度和AUC分別為88.3%、29.8%和0.602,其對術前N分期診斷的總體準確率為59.6%(31/52)。結論：磁共振DWI對胃癌淋巴結轉移具有較高的診斷價值,以ADC值及淋巴結短徑作為診斷標準可用于術前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.
【學位授予單位】：南京大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R445.2;R735.2

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本文編號：1992975