Comparative Study Of Color Doppler And MRI In Diagnosis Of Metastatic Neck Lymph Nodes Of Esophageal Cancer

Objective Compared with the two-field lymphadenectomy,three-field lymphadenectomy can reduce the local recurrence rate and improve survival rate,when treating thoracic esophageal cancer.but the postoperative complications will increase.Selective three-field lymph node dissection may benefit the patient.According to the characteristics of lymphatic metastasis of esophageal cancer,three-field lymph node dissection is mainly applied to patients with esophageal cancer associated with cervical or mediastinal lymph node metastasis.At present,there are many clinical method used for determination of cervical esophagus carcinoma metastasis lymph nodes.The purpose of this paper is to analyze the value of diagnosis and application of color Doppler and MRI on metastatsis of neck lymph nodes in patients with esophageal cancer.Methods Retrospectively reviewed esophageal cancer patients with dissecting cervical lymph nodes from October 2015 to October 2016.Among them,neck lymph nodes of 26 patients were simultaneously examined by color Doppler and MRI before surgical operation.Histopathological examination was regarded as a golden standard.Comparison between the diagnostic value of two kinds of imaging examination way was tested by ROC curve.Results 13 neck partitions were positive in the 31 neck partitions which were swept out from 26 patients and confirmed by postoperative pathological diagnosis.The sensitive of color Doppler and MRI were 76.92%and 53.84%;the specificity were 72.22%and 72.22%;The accuracy were 74.19%and 62.50%,respectively.ROC curve results suggest the diagnostic value of color Doppler is superior to MRI?At the same time,according to the postoperative pathological results,one patients in T1 phase with cervical lymph node metastasis(1/1),3 cases in T2 phase with cervical lymph node metastases(3/8),6 cases patients in T3 phase with cervical lymph node metastases(6/15),two patients in T4 phase with cervical lymph node metastases(2/2).The pathologic findings of 12 patients with cervical lymph node metastasis were observed.The pathological results of 8 cases(66.7%)showed that the lymph node metastasis of the neck was accompanied by lymph node metastasis of the recurrent laryngeal nerve;3 cases had skip metastasis of lymph node;I case of middle thoracic esophageal carcinoma and 2 cases of lower thoracic esophageal cancer have cervical lymph node metastasis without subcarinal,paraesophageal and recurrent laryngeal nerve lymph node metastasis.Conclusion Color Doppler and MRI are also useful for the diagnosis of metastatsis of neck lymph nodes of patients with esophageal cancer.Color Doppler can be regarded as the first choice because of the sensitive and accuracy of Color Doppler is higher than MRI and it is economical,simple,non-invasive and easy to repeat.At the same time,from the point of metastasis lymph node distribution in this study,even the stage T1 esophageal cancer should also be routine cervical color Doppler ultrasound for the diagnosis of cervical lymph nodes.