Narayanan Priya, Iyngkaran Thayahlan, Sohaib Syed A, Reznek Rodney H, Rockall Andrea G
Academic Department of Radiology, St Bartholomew's Hospital, Dominion House, 59 Bartholomew Close, London EC1A 7ED, England.
Radiographics. 2009 Jul-Aug;29(4):1057-69; discussion 1069-71. doi: 10.1148/rg.294085231.
Dissemination of tumor to lymph nodes is one of the principal routes of metastatic disease. The presence or absence of nodal disease is an important prognostic factor in gynecologic malignancies; thus, nodal staging is an integral part of the pretreatment assessment. It is vital that pretreatment nodal staging be accurate and reliable. Current imaging techniques such as computed tomography and magnetic resonance (MR) imaging have limitations because they rely almost exclusively on size criteria. MR lymphography uses a lymph node-specific contrast agent (ferumoxtran-10) composed of ultrasmall superparamagnetic iron oxide particles. The contrast agent is taken up by macrophages within benign lymph nodes and allows differentiation from malignant nodes on the basis of alterations in signal intensity. This technique has been shown to increase the sensitivity and specificity of detection of lymph node metastases independent of nodal size. However, as with any technique, there are pitfalls that the radiologist must be aware of to avoid interpretative errors.
肿瘤向淋巴结的扩散是转移性疾病的主要途径之一。有无淋巴结疾病是妇科恶性肿瘤的一个重要预后因素；因此，淋巴结分期是预处理评估不可或缺的一部分。预处理淋巴结分期准确可靠至关重要。目前的成像技术，如计算机断层扫描和磁共振成像，存在局限性，因为它们几乎完全依赖大小标准。磁共振淋巴造影使用由超小超顺磁性氧化铁颗粒组成的淋巴结特异性造影剂（ferumoxtran - 10）。该造影剂被良性淋巴结内的巨噬细胞摄取，并基于信号强度的改变实现与恶性淋巴结的区分。已证明该技术可提高独立于淋巴结大小的淋巴结转移检测的敏感性和特异性。然而，与任何技术一样，存在一些放射科医生必须注意避免解释错误的陷阱。
