MR microimaging of benign and malignant nodes in the neck
MR microimaging of benign and malignant nodes in the neck
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DOI：
10.2214/ajr.04.1832
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发表时间：
2006-03-01
影响因子：
5
通讯作者：
Nakamura, T
中科院分区：
文献类型：
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作者：
Sumi, M;Van Cauteren, M;Nakamura, T
OBJECTIVE.我们评估了高分辨率MRI在区分颈部可触及和浅表的良性和恶性颈部淋巴结方面的诊断标准。我们对26例患者颈部的24个经组织学证实的转移性淋巴结、14个经组织学证实的淋巴瘤和35个经组织学或临床证实的良性淋巴结进行了MR显微成像。使用47 mm显微镜线圈进行T1加权自旋回波、脂肪抑制T2加权快速自旋回波和自旋回波弥散加权平面回波序列成像。磁共振显微成像提供了高分辨率的图像的节点。转移性淋巴结、淋巴瘤和良性淋巴结的肝门脂肪丢失率分别为92%、79%和46%。在转移性淋巴结、淋巴瘤和良性淋巴结中，分别有58%、23%和9%的淋巴结边缘光滑。在T1或脂肪抑制的T2加权像上，或两者兼有，分别在88%、29%和23%的转移性淋巴结、淋巴瘤和良性淋巴结中观察到不均匀的淋巴结实质。三组淋巴结的表观扩散系数有显著性差异（p < 0.001），其中转移性淋巴结最高，良性淋巴结次之。Logistic回归分析显示，异质性淋巴结实质和表观扩散系数水平对鉴别转移性淋巴结有显著意义，表观扩散系数水平对鉴别淋巴瘤有显著意义。结合使用这些MR显微镜下结节结构和表观扩散系数标准，鉴别转移性结节和淋巴瘤的准确性分别为90%（敏感性86%，特异性94%）和93%（敏感性85%，特异性95%）。颈部淋巴结的结构和磁共振显微成像上的表观扩散系数水平可以为诊断颈部淋巴结的良恶性提供有用的信息。
OBJECTIVE. We evaluated the diagnostic criteria of high-resolution MRI in differentiating benign and malignant cervical nodes that were palpable and superficial in the neck.SUBJECTS AND METHODS. We performed MR microimaging on 24 histologically proven metastatic nodes, 14 histologically proven lymphomas, and 35 histologically or clinically proven benign nodes in the necks of 26 patients. The lymph nodes were imaged with T1-weighted spin-echo, fat-suppressed T2-weighted turbo spin-echo, and spin-echo diffusion-weighted echo-planar sequences using a 47-mm microscopy coil.RESULTS. MR microimaging provided high-resolution images of the nodes. Hilar fat was lost in 92%, 79%, and 46% of the metastatic nodes, lymphomas, and benign nodes, respectively. Smooth nodal margins were lost in 58%, 23%, and 9% of metastatic nodes, lymphomas, and benign nodes, respectively. Heterogeneous nodal parenchyma on T1- or fat-suppressed T2-weighted images, or both, was observed in 88%, 29%, and 23% of metastatic nodes, lymphomas, and benign nodes, respectively. The apparent diffusion coefficients were significantly different among these three node groups (p < 0.001), with metastatic nodes being the highest, followed by benign nodes. Logistic regression analyses showed that heterogeneous nodal parenchyma and apparent diffusion coefficient levels were significant in discriminating metastatic nodes, and apparent diffusion coefficient levels in discriminating lymphomas. Combined use of these MR microscopic criteria on nodal architecture and apparent diffusion coefficients yielded 90% accuracy (86% sensitivity, 94% specificity) and 93% accuracy (85% sensitivity, 95% specificity) for discriminating metastatic nodes and lymphomas, respectively.CONCLUSION. The nodal architecture and apparent diffusion coefficient levels on MR microimaging may provide useful information in diagnosing benign and malignant nodes in the neck.