| Objective:To explore the preoperative diagnostic value of lymph nodes in patients with gastric cancer by diffusion weighted (DW) MR imaging.Methods:Between December 2011 and December 2012, a total of fifty-two patients (34 men,18 women) who received a confirmed diagnosis of gastric cancer and admitted to the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School were underwent preoperative DW MR imaging. The ADC values and short diameter of lymph nodes were measured and compared with the post-operative histopathological findings. Diagnostic value of ADC value and short diameter for metastatic lymph nodes in patients with gastric cancer were compared by receiver characteristic curve (ROC) analysis.Results:A total of 180 metastatic and 57 non-metastatic lymph nodes were detected as hyperintense on DW images obtained from 52 patients. The ADC value of metastatic lymph nodes (1.059±0.196)×10-mm2/s was significantly lower than that of non-metastatic nodes(1.402±0.285)×10-3mm2/s, P<0.001. With the threshold ADC value of 1.189×10-3mm2/s, the sensitivity, specificity and area under the curve (AUC) were 78.9%,72.8% and 0.840. The overall diagnostic accuracy of preoperative N staging of ADC values was 80.8%(42/52). The short diameter of metastatic group (8.08±3.99mm) was significantly longer than that of non-metastatic group (6.75±2.70mm, P=0.005). With the threshold of short diameter of 5.05mm, the sensitivity, specificity and AUC were 88.3%,29.8% and 0.602. The overall diagnostic accuracy of preoperative N staging of short diameter was 59.6%(31/52).Conclusion:DW MR imaging is a useful technique in diagnosing metastatic lymph nodes in patients with gastric cancer. ADC values and short diameter could be used as a diagnostic criterion for the diagnosis of preoperative N staging. |
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