1.5T磁共振不同序列对宫颈癌盆腔淋巴结转移的诊断价值分析

Diagnostic Value of Different Sequences of 1.5T MRI in Pelvic Lymph Node Metastasis of Cervical Cancer

目的:探究1.5T磁共振不同序列对宫颈癌盆腔淋巴结转移的诊断价值,以期寻找出最佳的扫描序列条件。方法:选择2021年3月~2022年1月在本院确诊为宫颈癌的80例患者进行研究,均实施盆腔淋巴结清扫术,并在术前进行T1WI、T2WI、增强扫描、DWI MRI检测,以术后病理结果为金标准,分析不同MRI序列检出盆腔淋巴结数量及其分布情况。结果:80例患者共检出123枚肿大淋巴结,其中55枚为转移性淋巴结,68枚为非转移性淋巴结。DWI序列诊断盆腔转移性淋巴结的灵敏度、准确率显著高于T1WI、T2WI、增强扫描序列(P<0.05)。在DWI序列中,转移性淋巴结的ADC值、rADC值显著低于非转移性淋巴结(P<0.05)。且经ROC曲线分析显示,DWI序列中应用ADC值诊断盆腔转移淋巴结的灵敏度、特异性高于rADC值。结论:1.5T磁共振DWI序列对宫颈癌盆腔淋巴结转移有较高检出率,且应用ADC阈值法能够有效鉴别转移淋巴结与非转移淋巴结。

Objective:To explore the diagnostic value of different sequences of 1.5T magnetic resonance in pelvic lymph node metastasis of cervical cancer,in order to find the best scanning sequence conditions.Methods:80 cases of patients with cervical cancer diagnosed in our hospital from March 2021 to January 2022 were selected for study.All patients underwent pelvic lymph node dissection,and underwent T1WI,T2WI,enhanced scanning and DWI MRI before operation.Taking the postoperative pathological results as the gold standard,the number and distribution of pelvic lymph nodes detected by different MRI sequences were analyzed.Results:A total of 123 enlarged lymph nodes were detected in 80 patients,including 55 metastatic lymph nodes and 68 non metastatic lymph nodes.The sensitivity and accuracy of DWI sequence in the diagnosis of pelvic metastatic lymph nodes were significantly higher than the T1WI,T2WI and enhanced scanning sequence(P<0.05).In DWI sequence,the ADC value and rADC valueof metastatic lymph nodes were significantly lower than the non metastatic lymph nodes(P<0.05).ROC curve analysis showed that the sensitivity and specificity of ADC value in DWI sequence in the diagnosis of pelvic metastatic lymph nodes were higher than rADC value.Conclusion:1.5T magnetic resonance DWI sequence has a high detection rate for pelvic lymph node metastasis of cervical cancer,and ADC threshold method can effectively distinguish metastatic lymph nodes from non metastatic lymph nodes.