Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
MAGMA. 2011 Feb;24(1):1-8. doi: 10.1007/s10334-010-0226-7. Epub 2010 Sep 24.
To determine whether apparent diffusion coefficient (ADC) measurements allow discrimination of normal lymph nodes from lymphomatous lymph nodes, and indolent lymphomas from aggressive lymphomas in patients with non-Hodgkin lymphoma (NHL).
Eighteen healthy volunteers and thirty-two patients with newly diagnosed NHL (indolent: n = 16; aggressive: n = 16) underwent diffusion-weighted imaging. ADCs of normal lymph nodes were compared to those of lymphomatous lymph nodes, and ADCs of indolent lymphomas were compared to those of aggressive lymphomas. Receiver operating characteristic (ROC) analysis was performed when ADCs were significantly different between two of the aforementioned groups.
ADCs (in 10(-3) mm(2)/s) of lymphomatous lymph nodes (0.70 ± 0.22) were significantly lower (P < 0.0001) than those of normal lymph nodes (1.00 ± 0.15). Area under the ROC curve was 0.865. Sensitivity and specificity were 78.1 and 100% when using an optimal cutoff ADC value of 0.80. On the other hand, ADCs of indolent lymphomas (0.67 ± 0.21) were not significantly different (P = 0.2997) from those of aggressive lymphomas (0.74 ± 0.23).
ADC measurements show promise as a highly specific tool for the discrimination of normal lymph nodes from lymphomatous lymph nodes, but appear to be of no utility in differentiating indolent from aggressive lymphomas.
在非霍奇金淋巴瘤(NHL)患者中,评估表观扩散系数(ADC)测量值是否可用于鉴别正常淋巴结与淋巴瘤性淋巴结,以及惰性淋巴瘤与侵袭性淋巴瘤。
18 名健康志愿者和 32 名新诊断为 NHL 的患者(惰性组:n=16;侵袭性组:n=16)接受了扩散加权成像检查。对比了正常淋巴结与淋巴瘤性淋巴结之间的 ADC 值,并对比了惰性淋巴瘤与侵袭性淋巴瘤之间的 ADC 值。当两组之间 ADC 值有显著差异时,进行了受试者工作特征(ROC)分析。
淋巴瘤性淋巴结的 ADC 值(10(-3)mm(2)/s)(0.70±0.22)显著低于正常淋巴结(1.00±0.15)(P<0.0001)。ROC 曲线下面积为 0.865。当使用最佳截断 ADC 值 0.80 时,灵敏度和特异性分别为 78.1%和 100%。另一方面,惰性淋巴瘤的 ADC 值(0.67±0.21)与侵袭性淋巴瘤的 ADC 值(0.74±0.23)无显著差异(P=0.2997)。
ADC 测量值有望成为鉴别正常淋巴结与淋巴瘤性淋巴结的高度特异工具,但似乎对鉴别惰性与侵袭性淋巴瘤没有帮助。