Discrimination of metastatic cervical lymph nodes with diffusion-weighted MR imaging in patients with head and neck cancer.
Discrimination of metastatic cervical lymph nodes with diffusion-weighted MR imaging in patients with head and neck cancer.
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发表时间：
2003-09
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通讯作者：
M. Sumi;N. Sakihama;T. Sumi;M. Morikawa;M. Uetani;H. Kabasawa;K. Shigeno;Kuniaki Hayashi;Haruo Takahashi;Takashi Nakamura
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作者：
M. Sumi;N. Sakihama;T. Sumi;M. Morikawa;M. Uetani;H. Kabasawa;K. Shigeno;Kuniaki Hayashi;Haruo Takahashi;Takashi Nakamura
背景和目的颈淋巴结转移可能与淋巴结水扩散率和微循环的改变有关。我们测试了扩散加权磁共振成像是否可以区分转移性淋巴结。方法对经病理证实的颈部转移性淋巴结（25个）、良性淋巴结病（25个）和淋巴结瘤（5个）行MR扩散加权回波平面成像（DWI）和T1、T2加权成像。表观扩散系数（ADC）通过使用两个B因子（500和1000 s/mm（2））计算。结果转移性淋巴结的ADC值显著高于转移性淋巴结（0.410 +/- 0.105 x 10（-3）mm（2）/s，P = 0.400 x 10（-3）mm（2）/s），产生中等阴性预测值（71%）和高阳性预测值（93%）。受试者操作特征分析表明，T1或T2加权像异常信号强度（A（z）= 0.8437 +/- 0.0230）和ADC值（A（z）= 0.8440 +/- 0.0538）在鉴别转移性淋巴结方面提供了相似的诊断能力。高分化或中分化癌转移淋巴结的ADC值（0.440 +/- 0.020 x 10（-3）mm（2）/s，P <0.01）明显高于低分化癌（0.356 +/- 0.042 x 10（-3）mm（2）/s）。结论扩散加权成像有助于鉴别转移性淋巴结。
BACKGROUND AND PURPOSE Metastasis to the regional cervical lymph nodes may be associated with alterations in water diffusivity and microcirculation of the node. We tested whether diffusion-weighted MR imaging could discriminate metastatic nodes. METHODS Diffusion-weighted echo-planar and T1- and T2-weighted MR imaging sequences were performed on histologically proved metastatic cervical lymph nodes (25 nodes), benign lymphadenopathy (25 nodes), and nodal lymphomas (five nodes). The apparent diffusion coefficient (ADC) was calculated by using two b factors (500 and 1000 s/mm(2)). RESULTS The ADC was significantly greater in metastatic lymph nodes (0.410 +/- 0.105 x 10(-3) mm(2)/s, P /= 0.400 x 10(-3) mm(2)/s) yielded a moderate negative predictive value (71%) and high positive predictive value (93%). Receiver operating characteristic analysis demonstrated that the criteria of abnormal signal intensity on T1- or T2-weighted images (A(z) = 0.8437 +/- 0.0230) and ADC (A(z) = 0.8440 +/- 0.0538) provided similar levels of diagnostic ability in differentiating metastatic nodes. The ADC from metastatic nodes from highly or moderately differentiated cancers (0.440 +/- 0.020 x 10(-3) mm(2)/s, P <.01) was significantly greater than that from poorly differentiated cancers (0.356 +/- 0.042 x 10(-3) mm(2)/s). CONCLUSION Diffusion-weighted imaging is useful in discriminating metastatic nodes.