Role of diffusion-weighted echo-planar MR imaging in differentiation of residual or recurrent head and neck tumors and posttreatment changes
Role of diffusion-weighted echo-planar MR imaging in differentiation of residual or recurrent head and neck tumors and posttreatment changes
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DOI：
10.3174/ajnr.a0491
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发表时间：
2007-06-01
影响因子：
3.5
通讯作者：
Denewar, A.
中科院分区：
文献类型：
--
作者：
Razek, A. A. K. Abdel;Kandeel, A. Y.;Denewar, A.
背景和目的：本研究的目的是评估弥散加权 MR 成像是否可用于区分残留或复发性头颈肿瘤与术后或放射后的变化。 材料和方法：本研究包括 32 名临床怀疑术后复发头颈肿瘤的患者 (n = 3)、放疗 (n = 13) 或两者 (n = 16)。扩散加权磁共振成像是通过使用单次自旋回波平面序列完成的。计算可疑病变的表观弥散系数（ADC）值，并将其与病理结果相关联。结果：30例患者（93.8%）获得了足够的弥散加权MR图像和ADC图。残留或复发病灶的平均ADC值(1.17±0.33×10(-3)mm(2)/s)小于治疗后变化的ADC值(2.07+/-0.25×10(-3)mm(2)/s)，差异有统计学意义(P<0.001)。当ADC值1.30 X 10(-3) mm(2)/s作为分化阈值时，获得了最佳结果，准确度为87%，敏感性为84%，特异性为90%，阳性预测值为94%，阴性预测值为76%。结论：采用ADC测量的弥散加权MR成像对于区分残留或复发的头颈部肿瘤具有良好的结果。术后或放射后的变化。
BACKGROUND AND PURPOSE: The purpose of this work was to evaluate whether diffusion-weighted MR imaging can be used in differentiating residual or recurrent head and neck tumors from postoperative or postradiation changes.MATERIALS AND METHODS: This study included 32 patients clinically suspected for recurrent head and neck tumor after surgery (n = 3), radiation therapy (n = 13), or both (n = 16). Diffusion-weighted MR imaging was done by using a single-shot spin-echo echo-planar sequence. The apparent diffusion coefficient (ADC) value of the suspected lesion was calculated and correlated with pathologic results.RESULTS: Adequate diffusion-weighted MR images and ADC maps were obtained in 30 patients (93.8%). The mean ADC value of residual or recurrent lesions (1.17 0.33 X 10(-3) mm(2)/s) was less than that of posttherapeutic changes (2.07 +/- 0.25 x 10(-3) mm(2)/s), and the difference was statistically significant (P < .001). When an ADC value of 1.30 X 10(-3) mm(2)/s was used as a threshold value for differentiation, the best results were obtained with an accuracy of 87%, sensitivity of 84%, specificity of 90%, positive predictive value of 94%, and negative predictive value of 76%.CONCLUSIONS: Diffusion-weighted MR imaging with ADC measurement has promising results for differentiating residual or recurrent head and neck tumors from postoperative or postradiation changes.