Department of Radiology B, Universitary Hospital of Strasbourg, Strasbourg, France.
Eur Radiol. 2010 Aug;20(8):1803-11. doi: 10.1007/s00330-010-1736-4. Epub 2010 Feb 24.
To investigate the usefulness of diffusion-weighted imaging (DWI) to discriminate between metastatic and non-metastatic small lymph nodes in pelvic carcinoma.
A total of 259 patients (180 normal, 79 metastatic) prospectively underwent DWI at 3 T. We measured the short-axis diameter and the mean apparent diffusion coefficient (ADC) value. Lymph nodes with a short-axis diameter larger than 8 mm were recorded as being suspected metastatic lymph nodes. Imaging data were correlated station by station with histopathological results.
A total of 140 metastatic nodes were accurately matched with histology. On T2w, the short-axis diameter for non-metastatic and metastatic lymph nodes was 6.4 mm +/- 2.5 mm and 8.3 mm +/- 4.5 mm, respectively. Almost all metastatic or non-metastatic nodes had similar high signal intensity on DWI (except in 5 cases) with a homogeneous pattern. The mean ADC values (10(-3) mm(3)/s +/- standard deviation) of involved lymph nodes, control iliac nodes and control inguinal nodes were 924 +/- 217, 968 +/- 182 and 1,036 +/- 181, respectively. There were no statistically significant differences in the ADC of metastatic and non-metastatic nodes.
Isolated measurement of mean ADC values in a suspected station does not contribute to the diagnosis of metastatic nodes, in patients with small ambiguous nodes.
探讨弥散加权成像（DWI）在鉴别盆腔癌转移和非转移小淋巴结中的作用。
共 259 例患者（180 例正常，79 例转移）前瞻性地在 3T 行 DWI。我们测量短轴直径和平均表观扩散系数（ADC）值。短轴直径大于 8mm 的淋巴结记录为可疑转移淋巴结。对每一站的影像学数据与组织病理学结果进行相关性分析。
共 140 个转移淋巴结与组织病理学结果准确匹配。在 T2w 上，非转移和转移淋巴结的短轴直径分别为 6.4mm±2.5mm 和 8.3mm±4.5mm。除 5 例外，几乎所有转移或非转移淋巴结在 DWI 上均具有相似的高信号强度，表现为均匀模式。受累淋巴结、对照髂淋巴结和对照腹股沟淋巴结的平均 ADC 值（10(-3)mm(3)/s±标准差）分别为 924±217、968±182 和 1036±181。转移和非转移淋巴结的 ADC 值无统计学差异。
在可疑淋巴结中，孤立测量平均 ADC 值对诊断转移淋巴结没有帮助，尤其是在小而不确定的淋巴结中。
