Less contrast-enhanced areas within lymph nodes in the delayed phase of contrast-enhanced MRI: a suspicious finding for lymph node metastases
Less contrast-enhanced areas within lymph nodes in the delayed phase of contrast-enhanced MRI: a suspicious finding for lymph node metastases
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对比增强 MRI 延迟期淋巴结内对比增强区域较少：淋巴结转移的可疑发现
DOI：
10.1007/s10585-022-10161-y
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Takase K.
中科院分区：
文献类型：
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作者：
Mori N;Mugikura S;Takase K.
我们怀着极大的兴趣阅读了Dr. Sakamoto等人题为”Perfusion defects in non-enlarged metastatic lymph nodes using vessel wall magnetic resonance imaging：Detection performance and diagnostic value”的文章[1]。他们表明，三维（3D）对比增强（CE）血管壁（VW）磁共振成像（MRI）上淋巴结（LN）的灌注缺损（PD）可用于诊断非扩大的LN。在我们先前的研究中，使用对比增强超声（CE-US）的序列信号变化对乳腺癌患者进行了研究，我们对腋窝淋巴结进行了视觉和定量分析，发现转移性淋巴结比非转移性淋巴结更不均匀地增强，在早期阶段具有低峰值强度（PI）的区域，视觉上看起来增强较少，或灌注缺陷[2]。在子宫癌患者的盆腔淋巴结中证实了类似的结果[3]。作者的3D CE VW MR是在注射造影剂后几分钟进行的（即延迟相）。术语PD通常表示器官、组织和细胞的血流受损。因此，术语“灌注缺损”可能不适合用于指延迟期LN内对比度增强较少的区域。我们感兴趣的是，LN转移是否可能在早期阶段，立即注射造影剂后，在CE-MRI增强。为了证实作者在3D CE VW MR成像上延迟相的LN内的低增强区域是否是灌注缺陷，可能需要使用动态MRI在注射造影剂后立即评估序列信号变化。
We read with great interest the article by Dr. Sakamoto et al. titled” Perfusion defects in non-enlarged metastatic lymph nodes using vessel wall magnetic resonance imaging: Detection performance and diagnostic value”[1]. They showed that the perfusion defect (PD) of the lymph node (LN) on three-dimensional (3D) contrast-enhanced (CE) vessel wall (VW) magnetic resonance imaging (MRI) is useful in diagnosing non-enlarged LNs.In our previous studies using serial signal change of contrast-enhanced ultrasound (CE-US) for patients with breast cancer, we performed visual and quantitative analysis of axillary LNs and found that metastatic LNs were more heterogeneously enhanced than non-metastatic lymph nodes, with areas of low peak intensity (PI) in the early phase that visually appeared to be less enhanced, or perfusion defect [2]. Similar results were confirmed in pelvic LNs of patients with uterine cancer [3]. The authors’ 3D CE VW MR was performed several minutes after the injection of contrast media (ie, in the delayed phase). The term PD generally suggests impaired blood flow to organs, tissues, and cells. Therefore, the term “perfusion defect” may not be appropriate for referring to a less contrast-enhanced area within the LNs in the delayed phase. We were interested in whether LN metastasis might be enhanced in the early phase, immediately after the injection of contrast media in CE-MRI. To confirm whether the authors’ less enhanced area within LNs in the delayed phase on 3D CE VW MR imaging is a perfusion defect, the assessment of sequential signal changes immediately after the injection of contrast media using dynamic MRI might be needed.