Department of Radiology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Chin Med J (Engl). 2010 Oct;123(20):2820-4.
Diffusion weighted imaging with background suppression (DWIBS) is potentially useful in detecting metastatic lymph nodes. This study aimed to evaluate the efficacy of DWIBS at 3T magnetic resonance (MR) for diagnosing metastatic lymph nodes in cervical cancer.
This retrospective study included 25 patients with cervical cancer who underwent MR examination and were treated by hysterectomy and lymphadenectomy. The metastatic and non-metastatic lymph nodes were histologically proven by operation. Apparent diffusion coefficient (ADC) values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of all the identifiable lymph nodes were measured and compared.
Twenty-five primary tumor lesions, 17 metastatic lymph nodes and 140 non-metastatic lymph nodes were pathologically confirmed in 25 cases with cervical cancer. The difference of ADC values between primary tumor lesions, metastatic and non-metastatic lymph nodes were statistically significant (F = 7.93, P = 0.001). There was no statistically significant difference between primary tumor lesions of cervical cancer and metastatic lymph nodes (t = -0.75, P = 0.456), and the difference between primary tumor lesions and non-metastatic lymph nodes was statistically significant (t = 4.68, P < 0.001). The ADC values, long-axis diameters, short-axis diameters, ratio of short- to long-axis diameters of metastatic and non-metastatic lymph nodes were (0.86 ± 0.36) × 10(-3) mm(2)/s vs. (1.12 ± 0.34) × 10(-3) mm(2)/s, (1.51 ± 0.41) cm vs. (1.19 ± 0.36) cm, (1.16 ± 0.35) cm vs. (0.77 ± 0.22) cm, 0.78 ± 0.17 vs. 0.68 ± 0.19 respectively, and statistically significant difference existed between two groups.
DWIBS at 3T MR has the distinct advantages in detecting pelvic lymph nodes of cervical cancer. Quantitative measurement of ADC values could reflect the degree of restriction of diffusion of metastatic and non-metastatic lymph nodes. The combination of size and ADC value would be useful in the accurate diagnosis of metastatic lymph nodes.
背景抑制弥散加权成像（DWIBS）在检测转移性淋巴结方面具有潜在的应用价值。本研究旨在评估 3T 磁共振（MR）DWIBS 对宫颈癌转移性淋巴结的诊断效能。
本回顾性研究纳入 25 例宫颈癌患者，这些患者均接受了 MR 检查，并接受了子宫切除术和淋巴结切除术。通过手术对转移性和非转移性淋巴结进行组织学证实。测量并比较所有可识别淋巴结的表观扩散系数（ADC）值、长轴直径、短轴直径、短轴与长轴直径比。
25 例宫颈癌患者中，25 例患者的 25 个原发肿瘤病灶、17 个转移性淋巴结和 140 个非转移性淋巴结经病理证实。原发肿瘤病灶、转移性和非转移性淋巴结的 ADC 值差异具有统计学意义（F = 7.93，P = 0.001）。宫颈癌原发肿瘤病灶与转移性淋巴结之间的 ADC 值差异无统计学意义（t = -0.75，P = 0.456），而宫颈癌原发肿瘤病灶与非转移性淋巴结之间的差异具有统计学意义（t = 4.68，P < 0.001）。转移性和非转移性淋巴结的 ADC 值、长轴直径、短轴直径、短轴与长轴直径比分别为（0.86 ± 0.36）×10（-3）mm（2）/s 比（1.12 ± 0.34）×10（-3）mm（2）/s、（1.51 ± 0.41）cm 比（1.19 ± 0.36）cm、（1.16 ± 0.35）cm 比（0.77 ± 0.22）cm、0.78 ± 0.17 比 0.68 ± 0.19，两组间差异均有统计学意义。
3T MR 的 DWIBS 在检测宫颈癌盆腔淋巴结方面具有明显优势。ADC 值的定量测量可反映转移性和非转移性淋巴结扩散受限的程度。大小和 ADC 值的联合应用有助于准确诊断转移性淋巴结。
