The diagnostic value of chest CT and MRI for lymph node metastasis of thoracic esophageal cancer

Objective To compare the clinical value of chest CT and Magnetic Resonance Imaging (MRI) in the diagnosis of lymph node metastasis of thoracic esophageal cancer. Methods A retrospective analysis of 90 patients with thoracic esophageal cancer lymph node metastasis diagnosed and treated in our hospital from July 2015 to June 2019. All patients underwent chest CT and MRI scans after admission, and the lesion tissue samples were taken for pathological examination after surgery. Physical examination, with pathological diagnosis results as the gold standard, analyze the sensitivity and specificity of chest CT and MRI. Results The sensitivity, specificity, positive predictive value, and negative predictive value of MRI scan was 88.73%, 94.74%, 98.44%, and 69.23%, respectively, which were higher than 69.01%, 52.63%, 84.48%, and 31.25% of the chest CT scan. In the distribution of lymph node metastasis, the middle of the thorax was the largest, and the proportions of the upper, middle, and lower thoraxes were 26.67%, 60.00%, and 13.33%, respectively. The uppermost mediastinal and paratracheal lymph nodes had the largest metastases in the upper thorax, the paratracheal and subcarinal lymph nodes in the middle thoracic segment had the most metastasis, and the next to the cardia and left gastric artery lymph nodes in the lower thorax had the largest metastases. The accuracy of MRI diagnosis is higher than that of chest CT. Conclusion Both chest CT and MRI can diagnose lymph node metastasis of thoracic esophageal cancer. The diagnostic value of MRI in diagnosing lymph node metastasis of thoracic esophageal cancer is better than chest CT. The diagnostic accuracy of MRI in each part of the lymph node is higher than that of chest CT, which can show the lymph nodes more clearly in transfer situation. 摘要： 目的 比较胸部计算机断层扫描 (computer tomography, CT) 和磁共振成像 (magnetic resonance imaging, MRI) 判断胸段食管癌淋巴结转移的临床价值。 方法 回顾性分析2015年7月一2019年6月在我院诊治的胸段食管癌淋 巴结转移患者90例, 所有患者在入院后均采用胸部CT和MRI平扫及增强扫描, 并在手术后对病灶组织标本进行病 理学检测, 以病理诊断结果为金标准, 分析胸部CT和MRI灵敏度和特异度。 结果 MRI扫描, 灵敏度为88.73%, 特 异度为94.74%, 阳性预测值为98.44%, 阴性预测值为69.23%, 高于胸部CT扫描的69.01%、52.63%、84.48%、31.25%。淋巴结转移分布中, 胸中段最多, 胸上段、胸中段、胸下段所占比例分别为26.67%、60.00%、13.33%, 胸上段中 最上纵隔和气管旁淋巴结转移最多, 胸中段气管旁、隆突下淋巴结转移最多, 胸下段贲门旁、胃左动脉旁淋巴结转移最 多, MRI诊断准确率高于胸部CT。 结论 胸部CT、MRI均能够诊断出胸段食管癌淋巴结转移, MRI诊断胸段食管癌 淋巴结转移的诊断价值优于胸部CT, MRI在胸段淋巴结各部位的诊断准确率高于胸部CT, 能够更清晰显示淋巴结的 转移情况。