Chen Yun B, Liao Jiang, Xie Rong, Chen Gui L, Chen Gang
Department of Radiology, Fujian Medical University Teaching Hospital, Fujian Provincial Cancer Hospital, Fuzhou, People's Republic of China.
Abdom Imaging. 2011 Feb;36(1):102-9. doi: 10.1007/s00261-009-9590-z.
To evaluate the diagnostic value of diffusion-weighted MR imaging for differentiating metastatic and hyperplastic pelvic lymph nodes in patients with cervical carcinoma.
In this prospective study, 61 untreated patients were scanned with both morphological MR and diffusion-weighted imaging (DWI). Bilateral pelvic lymphadenectomy was then performed in all patients. Of the 1118 total dissected and histopathologically evaluated pelvic lymph nodes, 153 enlarged nodes with short-axis diameter larger than 5 mm were included for further study. The mean ADC values of all enlarged lymph nodes and the relative ADC values between tumors and nodes were also measured and, respectively, compared between the metastatic and hyperplastic node groups.
The mean ADC value of metastatic [(1.046 ± 0.198) × 10⁻³ mm²/s] nodes was significantly lower than that of hyperplastic [(1.289 ± 0.194) × 10⁻³ mm²/s] nodes (P < 0. 001). The relative ADC values between tumor and nodes were significantly lower in malignant [(0.19 ± 0.17) × 10⁻³ mm²/s] than hyperplastic [(0.4 ± 0.21) × 10⁻³ mm²/s] nodes (P < 0. 001). When a mean ADC value of 1.15 × 10⁻³ mm²/s was used as a threshold value for differentiating metastatic from hyperplastic nodes, the best results were obtained with a sensitivity of 83.3%, specificity of 74.7%, and accuracy of 78.4%.
DWI is useful in differentiating metastatic and hyperplastic pelvic lymph nodes in patients with cervical carcinoma.
评估磁共振扩散加权成像在鉴别宫颈癌患者盆腔转移性淋巴结和增生性淋巴结中的诊断价值。
在这项前瞻性研究中，对61例未经治疗的患者进行了形态学磁共振成像和扩散加权成像（DWI）扫描。然后对所有患者进行双侧盆腔淋巴结清扫术。在总共1118个经解剖和组织病理学评估的盆腔淋巴结中，纳入153个短轴直径大于5mm的肿大淋巴结进行进一步研究。还测量了所有肿大淋巴结的平均表观扩散系数（ADC）值以及肿瘤与淋巴结之间的相对ADC值，并分别在转移性淋巴结组和增生性淋巴结组之间进行比较。
转移性淋巴结的平均ADC值[（1.046±0.198）×10⁻³mm²/s]显著低于增生性淋巴结的平均ADC值[（1.289±0.194）×10⁻³mm²/s]（P<0.001）。肿瘤与淋巴结之间的相对ADC值在恶性淋巴结[（0.19±0.17）×10⁻³mm²/s]中显著低于增生性淋巴结[（0.4±0.21）×10⁻³mm²/s]（P<0.001）。当以1.15×10⁻³mm²/s的平均ADC值作为鉴别转移性淋巴结与增生性淋巴结的阈值时，获得了最佳结果，灵敏度为83.3%，特异度为74.7%，准确度为78.4%。
DWI有助于鉴别宫颈癌患者盆腔的转移性淋巴结和增生性淋巴结。
