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[PET/CT与MRI在鼻咽癌淋巴结转移诊断及N分期中的比较]

[Comparison between PET/CT and MRI in diagnosing lymph node metastasis and N staging of nasopharyngeal carcinoma].

作者信息

Zhang Gu-yi, Hu Wei-han, Liu Li-zhi, Wu Hu-bing, Gao Yuan-hong, Li Li, Pan Yi, Wang Quan-shi

机构信息

State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2006 May;28(5):381-4.

Abstract

OBJECTIVE

To compare the clinical significance of PET/CT and MRI in diagnosing lymph node metastasis and N staging of nasopharyngeal carcinoma (NPC).

METHODS

116 NPC patients had undergone PET/CT and MRI before therapy. The findings of PET/CT and MRI in diagnosing lymph node metastasis and N staging were compared according to the results of follow-up.

RESULTS

A total of 614 lymph nodes in 116 patients were analyzed. 340 positive nodes and 274 negative nodes interpreted by image findings were verified during follow-up. The sensitivity, specificity and accuracy of PET/CT in diagnosing node metastasis was 93.2%, 98.2% and 95.4%, while that of MRI was 88.8%, 91.2% and 89.9%, respectively, with statistically significant difference in each between PET/CT and MRI (P < 0.05). Based on Fuzhou Staging System, 109 patients (94.0%) were correctly staged by PET/CT, and 103 patients (88.8%) by MRI, while according to UICC Staging System, 108 patients (93.1%) were correctly staged by PET/CT, and 100 patients (86.2%) by MRI.

CONCLUSION

PET/CT is superior to MRI in diagnosing lymph node metastasis and N staging of nasopharyngeal carcinoma. The false-positive and false-negative assessment based on PET-CT scan findings may be caused by: (1) inflammatory hyperplastic node; (2) node with large areas of necrosis; (3) node in diameter less than spatial resolution limitation of PET.

摘要

目的

比较正电子发射断层显像/计算机断层扫描(PET/CT)与磁共振成像(MRI)在鼻咽癌(NPC)淋巴结转移诊断及N分期中的临床意义。

方法

116例NPC患者在治疗前接受了PET/CT和MRI检查。根据随访结果,比较PET/CT和MRI在诊断淋巴结转移及N分期方面的表现。

结果

共分析了116例患者的614个淋巴结。随访期间,影像检查发现的340个阳性淋巴结和274个阴性淋巴结得到证实。PET/CT诊断淋巴结转移的敏感性、特异性和准确性分别为93.2%、98.2%和95.4%,而MRI分别为88.8%、91.2%和89.9%,PET/CT与MRI之间各项差异均有统计学意义(P < 0.05)。基于福州分期系统,PET/CT正确分期109例患者(94.0%),MRI正确分期103例患者(88.8%);而根据国际抗癌联盟(UICC)分期系统,PET/CT正确分期108例患者(93.1%),MRI正确分期100例患者(86.2%)。

结论

在鼻咽癌淋巴结转移诊断及N分期方面,PET/CT优于MRI。基于PET-CT扫描结果的假阳性和假阴性评估可能由以下原因导致:(1)炎性增生性淋巴结;(2)大面积坏死的淋巴结;(3)直径小于PET空间分辨率限制的淋巴结。

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