Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Invest Radiol. 2009 Oct;44(10):683-90. doi: 10.1097/RLI.0b013e3181afbb36.
To assess the value of whole-body magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI), for the initial staging of malignant lymphoma, compared with computed tomography (CT).
Thirty-one consecutive patients with newly diagnosed malignant lymphoma prospectively underwent whole-body MRI (T1-weighted and short inversion time inversion recovery [n = 31], and DWI [n = 28]) and CT. Ann Arbor stages were assigned by 1 radiologist according to whole-body MRI findings, and by another radiologist according to CT findings. Differences in staging between whole-body MRI (without and with DWI) and CT were resolved using other (imaging) studies (including 18F-fluoro-2-deoxyglucose positron emission tomography and bone marrow biopsy) and follow-up studies as reference standard.
Staging results of whole-body MRI without DWI were equal to those of CT in 74% (23/31), higher in 26% (8/31), and lower in 0% (0/31) of patients, with correct/incorrect/unresolved overstaging relative to CT in 3, 2, and 2 patients, respectively, and incorrect staging of both modalities in 1 patient. Staging results of whole-body MRI with DWI were equal to those of CT in 75% (21/28), higher in 25% (7/28), and lower in 0% (0/28) of patients, with correct/incorrect overstaging relative to CT in 6 and 1 patient(s), respectively.
Our results suggest that initial staging of malignant lymphoma using whole-body MRI (without DWI and with DWI) equals staging using CT in the majority of patients, whereas whole-body MRI never understaged relative to CT. Furthermore, whole-body MRI mostly correctly overstaged relative to CT, with a possible advantage of using DWI.
评估全身磁共振成像（MRI），包括弥散加权成像（DWI），在恶性淋巴瘤初始分期中的价值，与计算机断层扫描（CT）相比。
31 例新诊断的恶性淋巴瘤患者前瞻性地接受全身 MRI（T1 加权和短反转时间反转恢复 [n = 31] 和 DWI [n = 28]）和 CT 检查。1 位放射科医生根据全身 MRI 结果，另一位放射科医生根据 CT 结果分配 Ann Arbor 分期。通过其他（影像学）研究（包括 18F-氟代-2-脱氧葡萄糖正电子发射断层扫描和骨髓活检）和随访研究作为参考标准，解决全身 MRI（无 DWI 和有 DWI）和 CT 之间的分期差异。
全身 MRI 无 DWI 的分期结果与 CT 相等的患者占 74%（23/31），高的占 26%（8/31），低的占 0%（0/31），分别有 3、2 和 2 例患者的正确/错误/未解决的过度分期相对于 CT，1 例患者两种方法的分期均不正确。全身 MRI 有 DWI 的分期结果与 CT 相等的患者占 75%（21/28），高的占 25%（7/28），低的占 0%（0/28），分别有 6 和 1 例患者相对于 CT 的正确/过度分期。
我们的结果表明，全身 MRI（无 DWI 和有 DWI）在大多数患者中的恶性淋巴瘤初始分期与 CT 相当，而全身 MRI 从未相对于 CT 分期过低。此外，全身 MRI 相对于 CT 大多正确地过度分期，DWI 可能具有优势。
