彩色B超、MRI在鼻咽癌N分期和淋巴结转移诊断中的比较

目的比较彩色B超与MRI在鼻咽癌N分期和淋巴结转移诊断中的价值。方法 65例鼻咽癌患者于治疗前行彩色B超和MRI检查（颈部淋巴结）。依随访结果,比较彩色B超和MRI在鼻咽癌N分期和颈部淋巴结转移诊断中的作用。结果按福州分期原则,彩色B超、MRI的N分期准确率分别为66.2%（43/65）,98.4%（64/65）,两者比较差异有统计学意义（P〈0.05）;65例患者的364个颈淋巴结的随访结果显示,阳性201个,阴性163个,彩色B超诊断颈部转移淋巴结的敏感性、特异性、准确性分别为97.7%,86.7%,87.4%,而MRI分别为96.0%,98.5%,96.9%,两者各指标间比较,在敏感性方面差异无统计学意义（P〉0.05）,而在特异性和准确性方面两者差异均有统计学意义（P〈0.05）。结论在鼻咽癌的N分期诊断方面MRI较彩色B超准确;MRI判断鼻咽癌颈淋巴结转移在敏感性方面和彩色B超无差异,在特异性、准确性方面较彩色B超准确,但也应警惕其假阳性和假阴性的判断。

Comparison of color Doppler ultrasonography with MRI in N staging and diagnosing lymph node metastasis of nasopharyngeal carcinoma

Objective To compare color Doppler ultrasonography with magnetic resonance imaging（MRI） in N staging and diagnosing lymph node metastasis of nasopharyngeal carcinoma（NPC）.Methods Sixty-five patients with NPC underwent color Doppler ultrasonography and MRI examination for neck lymph nodes before treatment.According to the follow-up results,the values of Doppler ultrasonography and MRI for N staging and diagnosing neck lymph node metastasis in NPC were compared.Results According to Fuzhou Staging Criteria 1992,the accuracy rate for N staging of MRI was higher than that of color Doppler ultrasonography（98.4% vs 66.2%,P〈0.05）.The follow-up results of 65 cases involving 364 neck lymph nodes showed that 201 nodes were positive and 163 were negative.The sensitivity,specificity and accuracy of diagnosing lymph node metastasis for color Doppler ultrasonography were 97.7%,86.7% and 87.4%,respectively;for MRI,those were 96.0%,98.5% and 96.9%,respectively.There was no significant difference in the sensitivity between two groups（P〉0.05）;while the specificity and accuracy for MRI were higher than those for ultrasonography（P〈0.05）.Conclusion MRI is superior to color Doppler ultrasonography in N staging and diagnosing neck lymph node metastasis of NPC.