Kozuka Takenori, Tomiyama Noriyuki, Johkoh Takeshi, Honda Osamu, Koyama Mitsuhiro, Hamada Seiki, Nakamura Hironobu, Yamamoto Shuji, Matsumoto Takashi
Department of Radiology, Osaka University Graduate School of Medicine, Japan.
Radiat Med. 2003 Jan-Feb;21(1):23-7.
To assess the detection and size of mediastinal and hilar lymph nodes by multiplanar reconstruction (MPR) view from isotropic voxel data sets obtained with multidetector-row computed tomography (MDCT).
Thin-section CT of 27 patients with mediastinal or hilar lymph node swelling was obtained with a 25.6-cm FOV, 512 x 512 matrix, and two protocols: A) 0.5-mm collimation, 0.3-mm interval, and B) 2-mm collimation, 1-mm interval. MPR views with a 0.5-mm slice thickness were obtained from these two data sets. Postcontrast axial CT used 5-mm collimation (set C). Two observers evaluated the presence and cranio-caudal length of swollen lymph nodes. Two other board-certified chest radiologists evaluated all three sets and established a gold standard by consensus.
The accuracy of detection was 76%, 73%, and 68% for sets A, B, and C, respectively. There was a significant difference between sets A and C (McNemar's test: p<0.05) but not between sets A and B or B and C (p>0.05). The cranio-caudal length of lymph nodes was significantly correlated with the gold standard only in set A (Pearson's correlation coefficient: r=0.53, p<0.05).
Non-contrast enhanced coronal MPR views constructed from isotropic voxel data sets may be substituted for axial enhanced CT for the evaluation of mediastinal and hilar lymph nodes.
通过多排螺旋计算机断层扫描（MDCT）获得的各向同性体素数据集的多平面重建（MPR）视图，评估纵隔和肺门淋巴结的检出情况及大小。
对27例纵隔或肺门淋巴结肿大患者进行薄层CT扫描，扫描参数为25.6 cm视野、512×512矩阵，采用两种扫描方案：A）准直0.5 mm、层间距0.3 mm；B）准直2 mm、层间距1 mm。从这两组数据集中获取层厚为0.5 mm的MPR视图。增强后轴位CT采用准直5 mm（设定C）。两名观察者评估肿大淋巴结的存在情况及头尾长度。另外两名经过委员会认证的胸部放射科医生评估所有三组图像，并通过共识建立金标准。
A组、B组和C组的检测准确率分别为76%、73%和68%。A组和C组之间存在显著差异（McNemar检验：p<0.05），但A组和B组之间以及B组和C组之间无显著差异（p>0.05）。仅在A组中，淋巴结的头尾长度与金标准显著相关（Pearson相关系数：r = 0.53，p<0.05）。
由各向同性体素数据集构建的非增强冠状MPR视图可替代增强轴位CT用于评估纵隔和肺门淋巴结。
