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MRI在胆囊癌淋巴结转移诊断中的价值 预览

The application value of MRI in diagnosing lymph node metastasis of gallbladder carcinoma
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摘要 目的探讨MRI在胆囊癌淋巴结转移诊断中的价值。方法分析手术病理证实的56例胆囊癌患者的MRI资料,并与病理结果对照,评价MRI对淋巴结转移的诊断效能。结果56例中85.37%的患者出现门腔静脉间隙-胰后组淋巴结转移,73.71%的患者出现腹腔动脉干组淋巴结转移,58.54%的患者出现腹主动脉组淋巴结转移,36.59%的患者出现肠系膜血管组淋巴结转移。MRI诊断淋巴结转移的灵敏度为73.17%,转移淋巴结分布:门腔静脉-胰后组占37.83%,腹腔干组占30.40%,腹主动脉组占26.35%,肠系膜血管组占12.16%。肠系膜组转移淋巴结短径明显小于门腔静脉间隙-胰后组、腹主动脉组和腹腔动脉干组(P<0.05)。淋巴结转移在MRT1WI图像上呈低信号,在T2WI图像上呈高信号,DWI序列呈明显高信号,ADC值明显减低。结论MRI在判断胆囊癌腹部淋巴结转移有较好的应用价值,淋巴结转移主要分布在门腔间隙-胰后组、腹腔动脉干组。 Objective To investigate the application value of magnetic resonance imaging(MRI) in diagnosing lymph node metastasis of gallbladder carcinoma.Methods The MRI data of 56 patients with gallbladder carcinoma that was identified by surgical pathological results in our hospital from 2014 to 2018 were analyzed,which were compared with those of pathological results to evaluate the diagnostic efficacy of MRI in diagnosis of lymph node metastasis of gallbladder carcinoma.Results Among the 56 patients,including 25 males and 31 females,aged from 40 to 71 years,with average age being(61.15±6.84) years,41 patients had lymph node metastasis(148 lymph nodes),and 85.37% of patients had lymph node metastasis in portal space-post pancreatic,73.71% of patients had lymph node metastasis around the celiac trunk,58.54% of patients had lymph node metastasis around abdominal aortic,36.59% of tpatients had lymph node metastasis around mesenteric perivascular.The sensitivity of MRI in diagnosis of lymph node metastasis was 73.17%,and the distribution of metastatic lymph nodes:the portal space-post pancreatic group accounted for 37.83%,and the celiac trunk group accounted for 30.40%,and the abdominal aortic group accounted for 26.35%,finally,the mesenteric perivascular group accounted for 12.16%.Moreover the short diameter of the metastatic lymph nodes in mesenteric perivascular group was(1.54±0.43) cm,which was significantly smaller than that in portal space-post pancreatic group [(2.78±0.89) cm],that in abdominal aortic group[(2.73±0.91) cm],and that[(2.70±0.95) cm]in celiac trunk group(P<0.05).In addition the lymph node metastasis showed low signal in MR T1 WI images,high signal in T2 WI images,and significantly high signal in DWI images,its corresponding ADC value was significantly decreased.Conclusion MRI has a good application value in judging the abdominal lymph node metastasis of gallbladder carcinoma,and the lymph node metastasis is mainly distributed around the portal spacepost pancreatic and around the celiac trunk.
作者 孙敏 张磊 董红焕 郭靖 宋彦澄 康立清 卢姗 张夏 SUN Min;ZHANG Lei;DONG Honghuan(Department of MRI,Cangzhou Municipal Central Hospital,Hebei,Cangzhou 061000,China)
出处 《河北医药》 CAS 2019年第14期2113-2116,2121共5页 Hebei Medical Journal
关键词 胆囊癌 淋巴结转移 磁共振成像 gallbladder carcinoma lymph node metastasis magnetic resonance imaging
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