Necrosis in metastatic neck nodes: Diagnostic accuracy of CT, MR imaging, and US
Necrosis in metastatic neck nodes: Diagnostic accuracy of CT, MR imaging, and US
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DOI：
10.1148/radiol.2303030157
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发表时间：
2004-03-01
期刊：
影响因子：
19.7
通讯作者：
van Hasselt, AC
中科院分区：
文献类型：
--
作者：
King, AD;Tse, GMK;van Hasselt, AC
目的：比较计算机断层扫描 (CT)、磁共振 (MR) 成像和超声检查 (US) 在检测头颈部鳞状细胞癌患者转移性颈部淋巴结坏死中的诊断准确性。 材料和方法：27 名头颈部鳞状细胞癌患者（年龄范围，39-85 岁；平均年龄，62 岁）接受了 CT、MR 成像和超声检查。三名放射科医生评估了图像中是否有淋巴结坏死。分析每种方式的结果的敏感性、特异性和准确性。以手术切除的病理分析作为参考标准。用 McNemar 试验比较这三种方法的特异性和敏感性。结果：病理检查发现 903 个淋巴结，其中 89 个为恶性。恶性淋巴结中有 43 个坏死。对 89 个恶性淋巴结坏死检测的分析表明，CT 的准确性、敏感性和特异性分别为 92%、91% 和 93%； MR 成像为 91%、93% 和 89%；美国的这一比例分别为 85%、77% 和 93%。所有成像方式均未能在 3 个淋巴结中描绘出 3 毫米或更小的坏死区域，并且超声检查中漏掉了另外 7 个淋巴结，CT 漏诊了 1 个淋巴结。七个淋巴结中的坏死无法与恶性肿瘤的其他成分（例如活肿瘤和疤痕组织）区分开来 3；磁共振成像，5；美国，3）。 MR 成像和 CT 的敏感性均为（CT，显着优于 US（分别为 P = .0082 和 P = .0339）。MR 成像和 CT 之间的敏感性（P = .3173）或三种模式的特异性没有显着差异。结论：MR 成像在检测坏死方面与 CT 相当。MR 成像和 CT 的敏感性优于 US。(C)北美放射学会，2004 年。
PURPOSE: To compare the diagnostic accuracy of computed tomography (CT), magnetic resonance (MR) imaging, and ultrasonography (US) in the detection of necrosis in metastatic cervical nodes from patients with head and neck squamous cell carcinoma.MATERIALS AND METHODS: Twenty-seven patients (age range, 39-85 years; mean age, 62 years) with squamous cell carcinoma in the head and neck underwent CT, MR imaging, and US. Three radiologists evaluated the images for nodal necrosis. The results of each modality were analyzed for sensitivity, specificity, and accuracy. Pathologic analysis of the surgical resection served as the reference standard. The three modalities were compared for specificity and sensitivity with the McNemar test.RESULTS: Pathologic examination revealed 903 nodes, of which 89 were malignant. Of the malignant nodes, 43 were necrotic. Analysis of the detection of necrosis in the 89 malignant nodes showed an accuracy, sensitivity, and specificity of 92%, 91%, and 93% for CT; 91%, 93%, and 89% for MR imaging; and 85%, 77%, and 93% for US, respectively. All imaging modalities failed to depict necrotic areas of 3 mm or smaller in three nodes, and necrosis was missed in an additional seven nodes with US and in one node with CT. Necrosis could not be distinguished from other components of malignancy, such as viable tumor and scar tissue, in seven nodes 3; MR imaging, 5; US, 3). The sensitivity of both MR imaging and CT was (CT, significantly better than that of US (P = .0082 and P = .0339, respectively). There was no significant difference in sensitivity (P = .3173) between MR imaging and CT, or in the specificity of the three modalities.CONCLUSION: MR imaging is comparable to CT for the detection of necrosis. The sensitivity of MR imaging and CT is better than that of US. (C) RSNA, 2004.