Hawnaur J M, Reynolds K, Wilson G, Hillier V, Kitchener H C
Department of Clinical Radiology, Manchester Royal Infirmary, Central Manchester and Manchester Children's University Hospitals NHS Trust, Manchester, UK.
Clin Radiol. 2002 Nov;57(11):995-1000. doi: 10.1053/crad.2002.1057.
Magnetic Resonance Imaging (MRI) has the potential to assess inguinal lymph nodes more accurately than palpation and less invasively than surgical exploration. The objective of this study was to measure the accuracy of MRI in identifying inguinal metastases by demonstrating abnormal lymph node morphology.
10 women with vulval malignancy underwent T1- and fat-suppressed T2-weighted surface coil MRI of both groins before surgery. Each groin was prospectively categorised as normal or as having metastatic lymphadenopathy using criteria established in normal volunteers. Histopathological findings in patients undergoing groin dissection for invasive vulval carcinoma were used as validation.
MRI had a positive predictive value of 89%, negative predictive value of 91%, sensitivity of 89%, specificity of 91% and accuracy of 90%. The most useful observations on MRI to identify metastatic lymphadenopathy were those of lymph node contour irregularity, cystic change in a lymph node, short axis diameter exceeding 10mm and abnormal long: short axis diameter ratio.
High resolution MRI of the inguinal regions has potential to screen for lymph node metastases in patients with vulval cancer, with the aim of reducing the number of women who have to undergo groin dissection.
磁共振成像（MRI）在评估腹股沟淋巴结方面，有可能比触诊更准确，且比手术探查侵入性更小。本研究的目的是通过显示异常淋巴结形态来测量MRI识别腹股沟转移灶的准确性。
10例患有外阴恶性肿瘤的女性在手术前接受了双侧腹股沟的T1加权和脂肪抑制T2加权表面线圈MRI检查。根据在正常志愿者中确立的标准，每个腹股沟被前瞻性地分类为正常或有转移性淋巴结病。对接受腹股沟清扫术的浸润性外阴癌患者的组织病理学检查结果用作验证。
MRI的阳性预测值为89%，阴性预测值为91%，敏感性为89%，特异性为91%，准确性为90%。MRI上识别转移性淋巴结病最有用的观察结果是淋巴结轮廓不规则、淋巴结囊性改变、短轴直径超过10mm以及长径与短径之比异常。
腹股沟区的高分辨率MRI有潜力筛查外阴癌患者的淋巴结转移，目的是减少必须接受腹股沟清扫术的女性人数。
