摘要目的 探讨大范围磁共振扩散加权成像对食管、贲门癌术前分级及淋巴结转移的效果.方法 35例食管癌术前行大范围MRI扩散加权成像,判定异常淋巴结数量及位置,与手术所见及术后病理结果对比.结果 大范围MRI扩散加权成像发现淋巴结转移23例,病理结果转移18例,大范围MRI弥散成像无淋巴结转移12例,病理结果无转移9例;大范围MRI扩散加权成像、病理结果欠符合7例,总符合率80%,锁骨上和纵隔淋巴结符合率达82.8%,腹部淋巴结符合率55.6%.结论 大范围MRI扩散加权成像对食管、贲门癌术前判断淋巴结转移较敏感,是食管、贲门癌术前评估淋巴结转移情况好方法,对直径<0.5 cm的淋巴结良恶性判定尚有不足.

abstractsObjective To study the effect of whole body diffusion weighted imaging(DWI) in detecting lymph node metastasis of esophageal cancer and cardia cancer, and its value in grading before operation. Methods 35 patients with esophageal cancer or cardiac cancer were performed the detection of DWI before operation to determine the number and location of the abnormal lymph nodes, then the results were compared with the finds in operation and the histopathological observations. Results 23 cases were found with lymph node metastasis by DWI in which 18 cases were confirmed by histopathology, while in 12 cases in which no lymph node metastasis was fonud by DWI there were 9 cases to be confirmed by histopathology; in 7 cases DWI did not well correspond with histopathology. The total accordance rate was 80%, while for supraclavicular lymph nodes and mediastinal lymph nodes the accordance rate was 82.5%, and for celiac lymph nodes the accordance rate was 55.6%. Conclusion DWI offers a high-sensitive means to estimate the lymph node metastasis of esophageal cancer and cardia cancer, but lack of sensitivity in judgement on the nature of benignity or malignancy for lymph nodes less than 0.5 cm in diameter.