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目的比较彩色多普勒超声与磁共振(MRI)对食管癌颈部淋巴结转移的诊断及临床应用价值。方法回顾性分析2015年10月至2016年10月南京医科大学第一附属医院胸外科行食管癌根治术合并颈部淋巴结清扫患者病例,其中26例术前同时行颈部彩色多普勒超声与MRI检查评价颈部淋巴结情况,以术后颈部淋巴结病理诊断结果为金标准,比较两种影像学检查方法的诊断价值。结果 26例患者共清扫31个颈部分区[美国癌症联合会(AJCC)颈部Ⅶ区法],其中术后病理确诊转移的颈部分区有13个。颈部彩色多普勒超声与MRI的灵敏度分别为76.92%、53.84%,特异度分别为72.22%、72.22%,准确率分别为74.19%、64.51%。ROC曲线结果提示彩色多普勒超声诊断价值优于MRI。结论食管癌术前行彩色多普勒超声与MRI检查均有助于辨别颈部淋巴结有无转移,彩色多普勒超声的敏感度和准确性高于MRI,可考虑为影像学检查的首选方法。
Objective To compare the diagnostic value of color Doppler ultrasound and magnetic resonance imaging (MRI) in cervical lymph node metastasis of esophageal cancer and its clinical value. Methods From October 2015 to October 2016, thoracic surgery of esophageal cancer combined with cervical lymph node dissection was performed in the First Affiliated Hospital of Nanjing Medical University. Twenty-six patients underwent preoperative neck color Doppler ultrasound MRI examination of cervical lymph nodes, postoperative neck lymph node pathological diagnosis as the gold standard, the diagnostic value of the two imaging methods. Results Twenty-six patients underwent neck dissection in 31 patients with neck region [AJCC]. There were 13 neck regions with pathologically confirmed metastases. The sensitivities of color Doppler ultrasound and MRI were 76.92% and 53.84% respectively, the specificity were 72.22% and 72.22% respectively, the accuracy rates were 74.19% and 64.51% respectively. ROC curve results suggest that color Doppler ultrasound diagnosis of better than MRI. Conclusion Preoperative color Doppler ultrasound and MRI examination of esophageal cancer are helpful to distinguish cervical lymph node metastasis, color Doppler ultrasound sensitivity and accuracy higher than MRI, may be considered the preferred method of imaging examination .