3.0T MRI常规序列联合DWI对肺癌术前T、N分期的诊断价值及其与病理的相关性研究
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摘要
目的研究3.0T磁共振成像(MRI)常规序列联合扩散加权成像(DWI)对肺癌术前T、N分期的诊断价值及其与病理的相关性。方法选择我院2015年8月至2017年7月收治的肺癌患者71例,均进行3.0T MRI常规序列联合DWI检查,以术后病理结果作为标准,分析3.0T MRI常规序列联合DWI检查对术前T、N分期结果及与病理结果相关性。结果 71例患者3.0T MRI常规序列联合DWI扫描对肺癌术前T分期诊断总精确度为92.96%,T_(1-2)期灵敏度、特异度和准确度依次为80.00%、100.00%和98.59%;T3期灵敏度、特异度和准确度依次为87.50%、94.55%和92.96%;T4期灵敏度、特异度和准确度依次为96.00%、90.48%和94.37%;与病理结果进行诊断一致性检验(κ=1.416,P>0.05)。71例患者3.0T MRI常规序列联合DWI扫描对肺癌术前N分期诊断总精确度为91.55%,N0期灵敏度、特异度和准确度依次为94.74%、96.97%和95.77%;N1期灵敏度、特异度和准确度依次为89.47%、92.31%和91.55%;N2-3期灵敏度、特异度和准确度依次为85.71%、98.25%和95.77%;与病理结果进行诊断一致性检验(κ=0.748,P>0.05)。结论 3.0T MRI常规序列联合DWI可作为肺癌术前T、N分期诊断的重要方法,与病理结果一致性较高。
Objective To study the diagnostic values of 3.0 T magnetic resonance imaging(MRI) routine sequence combined with diffusion-weighted imaging(DWI) in preoperative T and N stages of lung cancer and its correlation with pathology. MethodsA total of 71 cases of patients with lung cancer treated in our hospital from August 2015 to July 2017 were selected and were given 3.0 T MRI routine sequence combined with DWI examination. The postoperative pathological results were taken as criterion, and the preoperative T and N stages results of 3.0 T MRI combined with DWI and its correlation with pathological findings were analyzed. Results The total accuracy of preoperative T stage in 71 patients was 92.96% by 3.0 T MRI combined with DWI scan. The sensitivity, specificity and accuracy were 80.00%, 100.00% and 98.59% respectively at T_(1-2) stage, and were 87.50%, 94.55% and 92.96% respectively at T3 stage and were 96.00%, 90.48% and 94.37% at T4 stage. The results of consistency test diagnosis with pathology showed κ=1.416(P>0.05). The total accuracy of preoperative N stage in 71 patients was 91.55% by 3.0 T MRI combined with DWI scan. The sensitivity, specificity and accuracy were 94.74%, 96.97% and 95.77% at N0 stage, and were 89.47%, 92.31% and 91.55% at N1 stage and were 85.71%, 98.25% and 95.77% at N2-3 stage. The results of consistency test diagnosis with pathology showed κ=0.748(P>0.05). Conclusion 3.0 T MRI routine sequence combined with DWI can be used as important method for preoperative T and N stages of lung cancer diagnosis, and the consistency is high with pathological results.
Objective To study the diagnostic values of 3.0 T magnetic resonance imaging(MRI) routine sequence combined with diffusion-weighted imaging(DWI) in preoperative T and N stages of lung cancer and its correlation with pathology. MethodsA total of 71 cases of patients with lung cancer treated in our hospital from August 2015 to July 2017 were selected and were given 3.0 T MRI routine sequence combined with DWI examination. The postoperative pathological results were taken as criterion, and the preoperative T and N stages results of 3.0 T MRI combined with DWI and its correlation with pathological findings were analyzed. Results The total accuracy of preoperative T stage in 71 patients was 92.96% by 3.0 T MRI combined with DWI scan. The sensitivity, specificity and accuracy were 80.00%, 100.00% and 98.59% respectively at T_(1-2) stage, and were 87.50%, 94.55% and 92.96% respectively at T3 stage and were 96.00%, 90.48% and 94.37% at T4 stage. The results of consistency test diagnosis with pathology showed κ=1.416(P>0.05). The total accuracy of preoperative N stage in 71 patients was 91.55% by 3.0 T MRI combined with DWI scan. The sensitivity, specificity and accuracy were 94.74%, 96.97% and 95.77% at N0 stage, and were 89.47%, 92.31% and 91.55% at N1 stage and were 85.71%, 98.25% and 95.77% at N2-3 stage. The results of consistency test diagnosis with pathology showed κ=0.748(P>0.05). Conclusion 3.0 T MRI routine sequence combined with DWI can be used as important method for preoperative T and N stages of lung cancer diagnosis, and the consistency is high with pathological results.
引文
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[13]谢光辉,高运英,邱锦兴,等.磁共振全身扩散加权成像对肺癌的临床分期和疗效评估价值[J].安徽医药,2015,19(2):296-299.
[2]刘长浩,朱佳,刘宏旭.吸烟肺癌患者应用纤维支气管镜灌洗吸痰预防术后肺部感染[J].肿瘤学杂志,2017,23(5):445-447.
[3]程晓伟,朱龙飞,李勇.直接跨叶侵犯的非小细胞肺癌患者T分期及手术方式的探讨[J].国际呼吸杂志,2016,36(18):1384-1389.
[4]蔡文科,石云.非小细胞肺癌分期技术的应用研究及第七版肺癌分期的解析[J].国际肿瘤学杂志,2013,40(7):523-526.
[5]蔡晨曦,斯琴高娃.^18F-FDGPET-CT在肺癌SBRT疗效评价中的最新研究进展[J].实用医学杂志,2016,32(21):3619-3620.
[6]赵丹,余荣,胡俏俏,等.肺癌伴肺不张者放疗前MRI与CT模拟定位比较研究[J].中华放射肿瘤学杂志,2016,25(2):158-163.
[7]唐威,吴宁,欧阳汉,等.超高场强磁共振成像和多层螺旋CT扫描在非小细胞肺癌术前T分期中的应用价值[J].中华肿瘤杂志,2015,37(8):617-621.
[8]孙赛花,欧阳汉,余小多,等.比较3.0T MRI平扫及增强扫描对宫颈癌分期的价值[J].放射学实践,2014,29(2):145-148.
[9]向葵,干芸根,孙龙伟.膝关节相控阵线圈在新生儿脑部MRI检查中扫描参数优化选择[J].中国CT和MRI杂志,2015,13(11):30-32.
[10]孙照勇,张海波,李烁,等.多发性骨髓瘤多种磁共振成像序列图像质量的比较[J].中国医学科学院学报,2015,37(1):50-54.
[11]王颖,曲珊珊,孙西河,等.结直肠癌原发灶与肝转移灶的扩散成像比较[J].临床放射学杂志,2017,36(2):243-246.
[12]贺小平,苗重昌,卞光军,等.动态对比增强MRI与扩散加权成像在评价非小细胞肺癌化疗疗效中的研究[J].中华放射学杂志,2016,50(10):746-751.
[13]谢光辉,高运英,邱锦兴,等.磁共振全身扩散加权成像对肺癌的临床分期和疗效评估价值[J].安徽医药,2015,19(2):296-299.