Hagtvedt Trond, Aaløkken Trond Mogens, Smith Hans-Jørgen, Graff Bjørn Anton, Holte Harald, Kolbenstvedt Alf
Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
Acta Radiol. 2013 Apr 1;54(3):333-9. doi: 10.1258/ar.2012.120679. Epub 2013 Feb 27.
Previous studies of CT enhancement of lymphomatous lymph nodes (LLN) of the neck and the mediastinum showed that the LLN had lower enhancement values than normal lymph nodes.
To elucidate the contrast medium enhancement curves of LLN in the retroperitoneum by comparing the curves of LLN with those of normal lymph nodes, to test whether differences between these curves could be of diagnostic value, and to compare the present enhancement curves of LLN of the retroperitoneum with the curves of LLN of the neck and the mediastinum from previous similar investigations.
Twenty-eight consecutive patients with LLN of the retroperitoneum (three with Hodgkin's lymphoma [HL]) and 21 control patients with sarcomas and thus presumably normal retroperitoneal nodes underwent dynamic CT examinations. The previous, similar investigation of lymph nodes of the neck comprised 28 patients with LLN and the investigation of mediastinal lymph nodes comprised 24 patients with LLN.
The enhancement curves of the retroperitoneal LLN had significantly lower attenuation than those of the retroperitoneal control nodes. A combination of peak contrast value and time to peak adjusted to total body weight yielded a diagnostic accuracy which at the best showed a sensitivity of 90.5% with a specificity of 82.6%. The LLN of the retroperitoneum had higher attenuation values than corresponding nodes of the mediastinum but no significant difference was found between LLN of the retroperitoneum and LLN of the neck in previous similar investigations.
The comparison of enhancement curves of retroperitoneal LLN with retroperitoneal control nodes showed a marked similarity with and substantiates our previous findings in lymph nodes of the neck and of the mediastinum. The best diagnostic accuracy was achieved by combining the parameters peak contrast value and time to peak and adjusting these values to the body weight. Peak enhancement of the retroperitoneal LLN was higher and arrived earlier than that of the mediastinal nodes from the previous investigation.
先前对颈部和纵隔淋巴瘤性淋巴结（LLN）的CT增强研究表明，LLN的增强值低于正常淋巴结。
通过比较LLN与正常淋巴结的增强曲线，阐明腹膜后LLN的造影剂增强曲线，检验这些曲线之间的差异是否具有诊断价值，并将腹膜后LLN的当前增强曲线与先前类似研究中颈部和纵隔LLN的曲线进行比较。
连续28例腹膜后LLN患者（3例霍奇金淋巴瘤[HL]）和21例患有肉瘤且推测腹膜后淋巴结正常的对照患者接受了动态CT检查。先前对颈部淋巴结的类似研究包括28例LLN患者，对纵隔淋巴结的研究包括24例LLN患者。
腹膜后LLN的增强曲线衰减明显低于腹膜后对照淋巴结。将峰值对比值和达峰时间结合并根据总体重进行调整后，诊断准确率最高时显示敏感性为90.5%，特异性为82.6%。腹膜后LLN的衰减值高于纵隔相应淋巴结，但在先前类似研究中，腹膜后LLN与颈部LLN之间未发现显著差异。
腹膜后LLN与腹膜后对照淋巴结增强曲线的比较显示出明显相似性，证实了我们先前在颈部和纵隔淋巴结中的发现。通过结合峰值对比值和达峰时间参数并根据体重进行调整，可获得最佳诊断准确率。先前研究中，腹膜后LLN的峰值增强高于纵隔淋巴结，且达峰更早。
