Nakai Go, Matsuki Mitsuru, Inada Yuki, Tatsugami Fuminari, Tanikake Masato, Narabayashi Isamu, Yamada Takashi
Department of Radiology, Osaka Medical College, Osaka, Japan.
J Comput Assist Tomogr. 2008 Sep-Oct;32(5):764-8. doi: 10.1097/RCT.0b013e318153fd43.
In this study, the potential in detecting and evaluating pelvic lymph node metastases on body diffusion-weighted (DW) images was evaluated in patients with gynecologic malignancies.
This study included 18 patients with gynecologic malignancy who underwent magnetic resonance imaging in the pelvis using a 1.5-T superconductive magnet. The identification of pelvic nodes on only T2-weighted (T2W) axial images and on DW axial images in addition to T2W axial images was examined and compared. Moreover, we measured and calculated a short-axis diameter, a long-axis diameter, and a ratio of short- and long-axis diameter of nodes on the T2W images and the apparent diffusion coefficient (ADC) values of the nodes on the DW images. These results were compared with histopathologic results.
First, 136 (40%) of 340 dissected nodes were identified on T2W images, and 249 (73%) of 340 dissected nodes were identified on DW images in addition to T2W images. Second, the differences in the short-axis diameter, the long-axis diameter, and the ratio of short- and long-axis diameter on T2W images between metastatic and nonmetastatic nodes were not significant. The differences in the ADC values between metastatic and nonmetastatic nodes were not significant.
Body DW images are useful in detection of pelvic lymph nodes in patients with gynecologic malignancy. However, the measurement of ADC values does not contribute to a diagnosis of metastatic nodes.
在本研究中，对妇科恶性肿瘤患者体部扩散加权（DW）图像检测和评估盆腔淋巴结转移的潜力进行了评估。
本研究纳入了18例接受1.5-T超导磁体盆腔磁共振成像的妇科恶性肿瘤患者。检查并比较仅在T2加权（T2W）轴位图像上以及除T2W轴位图像外还在DW轴位图像上对盆腔淋巴结的识别情况。此外，我们测量并计算了T2W图像上淋巴结的短轴直径、长轴直径以及短轴与长轴直径之比，还有DW图像上淋巴结的表观扩散系数（ADC）值。将这些结果与组织病理学结果进行比较。
首先，在T2W图像上识别出340个切除淋巴结中的136个（40%），除T2W图像外在DW图像上识别出340个切除淋巴结中的249个（73%）。其次，转移淋巴结与非转移淋巴结在T2W图像上的短轴直径、长轴直径以及短轴与长轴直径之比的差异不显著。转移淋巴结与非转移淋巴结的ADC值差异也不显著。
体部DW图像有助于检测妇科恶性肿瘤患者的盆腔淋巴结。然而，ADC值的测量对转移淋巴结的诊断并无帮助。
