磁共振波谱评价乳腺癌淋巴结转移初探

Preliminary Exploration of Magnetic Resonance Spectrum in Evaluating Breast Cancer Lymph Node Metastasis

目的初步探讨磁共振波谱对乳腺癌淋巴结转移的应用价值。方法对21例35个腋窝或前哨淋巴结行磁共振波谱检测。采用Philips仪器点分辨自旋回波波谱，以扩散加权成像作为设置波谱体素位置的定位图，体素10～20mm-3，TR2000ms，TE38ms，采集次数128，激励次数8，检测前匀场2次。获得30个波谱数据（5个失败）。采用后处理软件包进行波谱图处理分析，观察在3．2ppm处有无胆碱（Cho）峰出现，如有记录病变的Cho峰信噪比（SNR）值。结果18个无转移的淋巴结6个有Cho峰，12个无Cho峰，平均SNR值1．6±0．96；12个有转移的淋巴结9个有Cho峰，3个无Cho峰，平均SNR值2．9±1．28。有无转移淋巴结Cho峰，所占比例差异无显著统计学意义（P=0．0604，〉0．05）；有无转移淋巴结Cho峰的SNR值差异有显著统计学意义（t=2．24，P〈0．05）。结论以有无Cho峰判断淋巴结有无转移值得商榷，有转移淋巴结Cho峰的SNR值较无转移者高，对评价淋巴结转移有一定价值。

Objective To explore the application value of magnetic resonance spectrum （MRS） for detecting breast cancer lymph node metastasis. Methods MRS examination was performed in 21 patients with breast cancer. DWI was set for spectrum voxel position chart in 35 enlarged lymph nodes. The spectrum data of lymph nodes were proceeded with post- processing software package, Peak in 3. 2 ppm presented as choline metabolites and the SNR values were recorded. Spec- trum data were obtained successfully in 30 lymph nodes. Results Six choline peak appeared in 18 lymph node without metastasis , mean SNR value was 1.6 ± 0.96 ; Nine choline peak appeared in 12 lymph node with metastasis , mean SNR value was 2.9 ±1.28. The choline peak proportion between metastasis lymph node and non metastasis lymph node had no significance difference （ P = 0.0604, 〉 0.05 ）. However, the choline peak SNR value between metastasis lymph node and non metastasis lymph node had significance difference （t = 2.24,P 〈 0.05 ）. Conclusion The choline peak SNR value in metastasis lymph node is higher than that in non-metastasis lymph node, and it was helpful in evaluating lymph node me- tastasis.