在选择接受根治性膀胱切除术的患者中进行弥散加权磁共振成像：盆腔淋巴结转移的检出率。
Diffusion-weighted magnetic resonance imaging in patients selected for radical cystectomy: detection rate of pelvic lymph node metastases.
机构信息
Radiology Department, University Campus Bio Medico, Rome, Italy.
出版信息
BJU Int. 2012 Apr;109(7):1031-6. doi: 10.1111/j.1464-410X.2011.10446.x. Epub 2011 Aug 25.
OBJECTIVE
To evaluate whether DW-MRI improves the detection of pelvic lymph nodes metastates in patients with bladder cancer undergoing radical cystectomy.
PATIENTS AND METHODS
36 patients with CT scan negative for nodal metastates underwent DW-MRI before surgery. Diagnostic accuracy of DW-MRI was compared with histopathological findings.
RESULTS
Mean ADC value was 0.85 × 10(-3) mm(3)/s in the nodal metastatic group and 1 × 10(-3) mm(3)/s in the nodal non-metastatic group (P = 0.02). The ADC cut-off value, obtained by the ROC curve was 0.86 × 10(-3) mm(3)/s. Patient-based sensitivity, specificity and positive and negative predictive values were 76.4%, 89.4%, 26.6%, and 71.4%, respectively.
CONCLUSION
DW-MRI may be used to differentiate metastatic from non-metastatic lymph nodes in patients with high-grade bladder cancer.
目的
评估磁共振弥散加权成像（DW-MRI）是否能提高膀胱癌行根治性膀胱切除术患者盆腔淋巴结转移的检出率。
患者与方法
36 例 CT 扫描未见淋巴结转移的患者在术前进行了 DW-MRI 检查。DW-MRI 的诊断准确性与组织病理学检查结果进行了比较。
结果
淋巴结转移组的平均 ADC 值为 0.85×10(-3)mm(3)/s，淋巴结无转移组为 1×10(-3)mm(3)/s（P=0.02）。通过 ROC 曲线获得的 ADC 截断值为 0.86×10(-3)mm(3)/s。以患者为基础的敏感性、特异性、阳性预测值和阴性预测值分别为 76.4%、89.4%、26.6%和 71.4%。
结论
DW-MRI 可用于区分高级别膀胱癌患者中转移性和非转移性淋巴结。
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