Objective: The diagnostic efficacy of the apparent diffusion coefficient (ADC) in diffusion-weighted magnetic resonance imaging (DW-MRI) for lymph node metastasis in biliary tract cancer was investigated in the present study.Methods: In total, 112 surgically resected lymph nodes from 35 biliary tract cancer patients were examined in this study. The mean and minimum ADC values of the lymph nodes as well as the long-axis and short-axis diameters of the lymph nodes were assessed by computed tomography (CT). The relationship between these parameters and the presence of histological lymph node metastasis was evaluated.Results: Histological lymph node metastasis was detected in 31 (27.7%) out of 112 lymph nodes. Metastatic lymph nodes had a significantly larger short-axis diameter compared with non-metastatic lymph nodes (p= 0.002), but the long-axis diameter was not significantly different between metastatic and non-metastatic lymph nodes. The mean and minimum ADC values for metastatic lymph nodes were significantly reduced compared with those for non-metastatic lymph nodes (p< 0.001 for both). However, the minimum ADC value showed the highest accuracy for the diagnosis of histological lymph node metastasis, with an area under the curve of 0.877, sensitivity of 87.1%, specificity of 82.7%, and accuracy of 83.9%.Conclusions: The minimum ADC value in DW-MRI is highly effective for the diagnosis of lymph node metastasis in biliary tract cancer. Accurate preoperative diagnosis of lymph node metastasis in biliary tract cancer should enable the establishment of more appropriate treatment strategies.
目的：本研究旨在探讨扩散加权磁共振成像（DWI）中表观扩散系数（ADC）对胆道癌淋巴结转移的诊断效能。 方法：本研究共纳入35例胆道癌患者手术切除的112枚淋巴结。通过计算机断层扫描（CT）评估淋巴结的平均ADC值、最小ADC值以及淋巴结的长径和短径，并分析这些参数与组织学淋巴结转移之间的关系。 结果：在112枚淋巴结中，31枚（27.7%）检出组织学淋巴结转移。转移性淋巴结的短径显著大于非转移性淋巴结（p=0.002），而长径在两组间无显著差异。转移性淋巴结的平均ADC值和最小ADC值均显著低于非转移性淋巴结（两者p<0.001）。其中，最小ADC值对组织学淋巴结转移的诊断准确率最高，曲线下面积为0.877，敏感性为87.1%，特异性为82.7%，准确率为83.9%。 结论：DWI中的最小ADC值对胆道癌淋巴结转移的诊断具有高效能。术前准确诊断胆道癌淋巴结转移有助于制定更合适的治疗策略。
肿瘤(癌症)患者之家