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PET/CT与MRI在鼻咽癌淋巴结转移诊断和N分期中的比较研究
作者姓名:Zhang GY  Hu WH  Liu LZ  Wu HB  Gao YH  Li L  Pan Y  Wang QS
作者单位:1. 510060,广州,中山大学肿瘤防治中心放疗科华南肿瘤学国家重点实验室
2. 510060,广州,中山大学肿瘤防治中心影像介入科
3. 南方医科大学南方医院
摘    要:目的 比较PET/CT与MRI在鼻咽癌淋巴结转移诊断和N分期中的作用。方法116例鼻咽癌患者于治疗前行PET/CT和MRI检查。依据随访结果比较PET/CT和MRI在淋巴结转移诊断和N分期中的作用。结果116例患者的614个淋巴结的随访结果显示,阳性340个,阴性274个。PET/CT诊断转移淋巴结的敏感性、特异性及准确性分别为93.2%、98.2%和95.4%,而MRI分别为88.8%、91.2%和89.9%,两者各指标比较,差异有统计学意义(P〈0.05)。按1992年福州分期,109例(94.0%)的PET/CT分期正确,103例(88.8%)的MRI分期正确;按UICC分期,108例(93.1%)的PET/CT分期正确,100例(86.2%)的MRI分期正确。结论PET/CT判断鼻咽癌淋巴结转移和N分期较MRI准确,但对炎性增生、大面积坏死淋巴结,或直径小于PET空间分辨率的转移淋巴结应警惕其假阳性和假阴性判断。

关 键 词:鼻咽肿瘤  诊断  体层摄影术  发射型计算机  磁共振成像  淋巴结转移
收稿时间:03 25 2005 12:00AM
修稿时间:2005-03-25

Comparison between PET/CT and MRI in diagnosing lymph node metastasis and N staging of nasopharyngeal carcinoma
Zhang GY,Hu WH,Liu LZ,Wu HB,Gao YH,Li L,Pan Y,Wang QS.Comparison between PET/CT and MRI in diagnosing lymph node metastasis and N staging of nasopharyngeal carcinoma[J].Chinese Journal of Oncology,2006,28(5):381-384.
Authors:Zhang Gu-yi  Hu Wei-han  Liu Li-zhi  Wu Hu-bing  Gao Yuan-hong  Li Li  Pan Yi  Wang Quan-shi
Institution:State Key Laboratory of Oncology in Southern China, Department of Radiation Oncology , Cancer Center, Sun Yat-sen University, Guangzhou 510060, China
Abstract:Objective To compare the clinical significance of PET/CT and MRI in diagnosing lymph node metastatsis and N staging of nasopharyngeal carcinoma ( NPC). Methods 116 NPC patients had undergone PET/CT and MRI before therapy. The findings of PET/CT and MRI in diagnosing lymph node metastatsis and N staging were compared according to the results of follow-up. Results A total of 614 lymph nodes in 116 patients were analyzed. 340 positive nodes and 274 negative nodes interpreted by image findings were verified during follow-up. The sensitivity, specificity and accuracy of PET/CT in diagnosing node metastatsis was 93. 2% , 98. 2% and 95. 4% , while that of MRI was 88. 8% , 91. 2% and 89. 9% , respectively, with statistically significant difference in each between PET/CT and MRI (P<0.05). Based on Fuzhou Staging System, 109 patients (94. 0%) were correctly staged by PET/CT, and 103 patients (88. 8% ) by MRI, while according to UICC Staging System, 108 patients (93. 1% ) were correctly staged by PET/CT, and 100 patients (86.2% ) by MRI. Conclusion PET/CT is superior to MRI in diagnosing lymph node metastatsis and N staging of nasopharyngeal carcinoma. The false-positive and false-negative assessment based on PET-CT scan findings may be caused by; ( 1) inflammatory hyperplastic node; ( 2 ) node with large areas of necrosis; (3) node in diameter less than spatial resolution limitation of PET.
Keywords:Nasopharyngeal neoplasm/diagnosis  Tomography  Emission-computed  Magnetic resonance imaging  Nodal metastatsis
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