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目的初步探讨磁共振波谱对乳腺癌淋巴结转移的应用价值。方法对21例35个腋窝或前哨淋巴结行磁共振波谱检测。采用Philips仪器点分辨自旋回波波谱,以扩散加权成像作为设置波谱体素位置的定位图,体素10~20 mm3,TR 2000 ms,TE 38 ms,采集次数128,激励次数8,检测前匀场2次。获得30个波谱数据(5个失败)。采用后处理软件包进行波谱图处理分析,观察在3.2 ppm处有无胆碱(Cho)峰出现,如有记录病变的Cho峰信噪比(SNR)值。结果 18个无转移的淋巴结6个有Cho峰,12个无Cho峰,平均SNR值1.6±0.96;12个有转移的淋巴结9个有Cho峰,3个无Cho峰,平均SNR值2.9±1.28。有无转移淋巴结Cho峰,所占比例差异无显著统计学意义(P=0.0604,>0.05);有无转移淋巴结Cho峰的SNR值差异有显著统计学意义(t=2.24,P<0.05)。结论以有无Cho峰判断淋巴结有无转移值得商榷,有转移淋巴结Cho峰的SNR值较无转移者高,对评价淋巴结转移有一定价值。
Objective To investigate the clinical value of magnetic resonance spectroscopy in detecting lymph node metastasis in breast cancer. Methods Magnetic resonance spectroscopy was performed in 21 cases of 35 axillary or sentinel lymph nodes. Using Philips point-resolved spin-echo spectroscopy, diffusion-weighted imaging was used as the localization map for setting the voxel position of the spectrum. The voxel was 10-20 mm3, TR 2000 ms, TE 38 ms, the number of acquisitions 128, the number of excitation 8, Field 2 times. Get 30 spectral data (5 failed). The post-processing software package was used for spectroscopic analysis to observe whether there was a Cho peak at 3.2 ppm, and if Cho signal-to-noise ratio (SNR) value of the lesions was recorded. Results Six of 18 non-metastatic lymph nodes had Cho peak and 12 no Cho peak, with an average SNR value of 1.6 ± 0.96. There were 9 Cho peaks and 9 No Cho peaks in 12 metastatic lymph nodes with an average SNR value of 2.9 ± 1.28 . There was no significant difference in the proportion of Cho peak between the two groups (P = 0.0604,> 0.05). There was significant difference in the SNR value of Cho peak between metastatic lymph nodes (t = 2.24, P <0.05). Conclusions The presence or absence of Cho peak to determine the presence or absence of metastasis of lymph nodes is questionable. There is a high value of SNR of Cho peak in metastatic lymph nodes compared with those without metastasis, which is valuable for evaluating lymph node metastasis.