Tang Yibo, Rao Shengxiang, Yang Chun, Hu Yabin, Sheng Ruofan, Zeng Mengsu
Shanghai Institute of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
J Surg Oncol. 2018 Sep;118(3):544-550. doi: 10.1002/jso.25173. Epub 2018 Aug 21.
To investigate the different features between metastatic lymph node and nonmetastatic lymph node on magnetic resonance imaging (MRI) and the relationship between the rectal lesion and lymph node metastasis (LNM).
Eighty-two patients with retrospectively consecutive pT1-2 stage rectal cancer in 2016 were divided into lymph node metastasis (LNM+) and lymph node nonmetastasis (LNM-) group based on their histopathologic examinations. We evaluated the following features of lymph nodes: number, shape, signal heterogeneity, border, and diameter of the largest lymph node on T2-weight images. We also calculated tumor apparent diffusion coefficient ratio and tumor percent enhancement. Fisher's exact test was applied for inspecting lymph node numbers on MRI and logistic regression analysis in examining risk factors for LNM.
The MR-LN number was significantly different between the LNM+ and LNM- group (median: 4 vs 1, P = 0.001). Multivariate logistic regression analysis exhibited that the diameter of the largest lymph node and the tumor percent enhancement of the arterial phase were independent risk factors of LNM (P = 0.005 vs 0.021, respectively).
The largest lymph node's diameter and the tumor percent enhancement of arterial phase on MRI were helpful in determining LNM in pT1-2 rectal cancer.
探讨磁共振成像（MRI）上转移性淋巴结与非转移性淋巴结的不同特征，以及直肠病变与淋巴结转移（LNM）之间的关系。
回顾性分析2016年连续收治的82例pT1-2期直肠癌患者，根据组织病理学检查结果分为淋巴结转移（LNM+）组和无淋巴结转移（LNM-）组。我们评估了淋巴结的以下特征：T2加权图像上淋巴结的数量、形态、信号异质性、边界以及最大淋巴结的直径。我们还计算了肿瘤表观扩散系数比值和肿瘤强化百分比。采用Fisher精确检验分析MRI上的淋巴结数量，并通过逻辑回归分析确定LNM的危险因素。
LNM+组和LNM-组的磁共振成像淋巴结数量有显著差异（中位数：4对1，P = 0.001）。多因素逻辑回归分析显示，最大淋巴结直径和动脉期肿瘤强化百分比是LNM的独立危险因素（P分别为0.005和0.021）。
MRI上最大淋巴结直径和动脉期肿瘤强化百分比有助于确定pT1-2期直肠癌的LNM情况。
