Perfusion defects in non-enlarged metastatic lymph nodes using vessel wall magnetic resonance imaging: Detection performance and diagnostic value
Perfusion defects in non-enlarged metastatic lymph nodes using vessel wall magnetic resonance imaging: Detection performance and diagnostic value
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DOI：
10.1007/s10585-022-10147-w
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发表时间：
2022-02-04
影响因子：
4
通讯作者：
Kodama, Tetsuya
中科院分区：
文献类型：
--
作者：
Sakamoto, Maya;Kojima, Ikuho;Kodama, Tetsuya
口腔鳞状细胞癌（OSCC）的非肿大淋巴结（LN）中的灌注缺损（PD）是诊断转移的最可靠的放射学标准。然而，由于颈部血管的流动伪影，使用快速自旋回波（TSE）序列的常规对比增强（CE）T1加权图像在检测非扩大LN中的PD方面受到限制。血管壁（VW）磁共振成像与血管流动抑制和高空间分辨率可能会提供新的见解PD的检测。然而，在文献中还没有关于VW MR成像诊断LN转移的有用性的报道。结果表明，在口腔鳞癌患者的CEVR MR成像中，未扩大淋巴结的PD有助于诊断转移性淋巴结。VW MR成像在检测非扩大转移性淋巴结的PD方面比常规TSE成像更敏感。此外，还发现，在CE VW MR图像中PD与周围结内组织之间的图像对比度高于常规CE TSE图像。在转移性淋巴结的成像和组织病理学结果之间的相关性中，所有在CE VW MR图像上显示PD的淋巴结均处于晚期组织病理学转移阶段。PD的病理表现为坏死组织角化。结果表明，PD在CE VW成像是有用的诊断非扩大淋巴结在晚期转移阶段。在常规MR检查的基础上增加VW MR成像可提高非扩大转移性淋巴结的诊断性能。
A perfusion defect (PD) in non-enlarged lymph nodes (LNs) of oral squamous cell carcinoma (OSCC) is the most reliable radiological criterion for the diagnosis of metastasis. However, conventional contrast-enhanced (CE) T1 weighted images using turbo spin echo (TSE) sequence is limited in detecting PD in non-enlarged LNs due to flow artifacts from cervical blood vessels. Vessel wall (VW) MR imaging with blood vessel flow suppression and high spatial resolution may provide new insights into the detection of PD. However, there are no reports in the literature on the usefulness of VW MR imaging for the diagnosis of LN metastasis. It is demonstrated that PD of non-enlarged LNs in CE VR MR imaging of OSCC patients is useful for the diagnosis of metastatic LNs. VW MR imaging was significantly more sensitive in detecting PD of non-enlarged metastatic LNs than conventional TSE imaging on visual evaluation. Furthermore, it was found that the image contrast between PD and surrounding intranodal tissue in CE VW MR images was higher than that in conventional CE TSE images. In the correlation between imaging and histopathological findings of metastatic LNs, all LNs that exhibited PD on CE VW MR images were at an advanced histopathological metastatic stage. The pathology of PD was necrotic tissue with keratinization. The results indicated that PD in CE VW imaging is useful in diagnosing non-enlarged LNs at an advanced metastasis stage. The addition of VW MR imaging to conventional MR examination achieves higher diagnostic performance for non-enlarged metastatic LNs.