Comparison of CT and MR imaging in staging of neck metastases
Comparison of CT and MR imaging in staging of neck metastases
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DOI：
10.1148/radiology.207.1.9530307
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发表时间：
1998-04-01
期刊：
影响因子：
19.7
通讯作者：
McNeil, BJ
中科院分区：
文献类型：
--
作者：
Curtin, HD;Ishwaran, H;McNeil, BJ
目的：比较磁共振成像(MR)和CT对头颈部鳞状细胞癌淋巴结转移的诊断价值。材料和方法：对已知的口腔、口咽、下咽、喉癌患者按标准方案进行MR和CT检查。进行组织病理学检查以确认影像表现。1991年至1994年，三个机构共收治213例311例颈淋巴清扫术患者。结果：对于上颈静脉和脊柱附件区域，受试者操作特征曲线下的面积分别为0.80和0.75。计算具有和不具有内部异常信息的各种大小标准的敏感性、特异性、阴性预测值(NPV)和阳性预测值(PPV)。用1厘米大小或内部异常来显示阳性结节，CT的NPV为84%，PPV为50%，而MR成像的NPV为79%，PPV为52%。CT的NPV为90%，与PPV的44%相关，使用5 mm大小作为阳性结节的指标。结论：在所有解释标准中，CT的表现略好于MR成像。然而，只有当使用低尺寸标准时，才能获得高净现值，因此与相对低的PPV相关。
PURPOSE: To compare the abilities of magnetic resonance (MR) imaging and computed tomography (CT) in detection of lymph node metastasis from head and neck squamous cell carcinoma.MATERIALS AND METHODS: MR imaging and CT were performed with standard protocols in patients with known carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx. Histopathologic examination was performed to validate imaging findings. Between 1991 and 1994, 213 patients undergoing 311 neck dissections were accrued at three institutions.RESULTS: For the upper jugular and spinal accessory regions, the areas under the receiver operating characteristic curve for combined information on size and internal abnormality were 0.80 for CT and 0.75 for MR imaging. Sensitivities, specificities, negative predictive values (NPVs), and positive predictive values (PPVs) were calculated for various size criteria with and without internal abnormality information. With use of a 1-cm size or an internal abnormality to indicate a positive node, CT had an NPV of 84% and a PPV of 50%, and MR imaging had an NPV of 79% and a PPV of 52%. CT achieved an NPV of 90%, correlating with a PPV of 44%, with use of 5-mm size as an indicator of a positive node.CONCLUSIONS: CT performed slightly better than MR imaging for all interpretative criteria. However, a high NPV was achieved only when a low size criterion was used and was therefore associated with a relatively low PPV.