Kato Hiroki, Kanematsu Masayuki, Watanabe Haruo, Mizuta Keisuke, Aoki Mitsuhiro
Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan(1).
Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan(1); High-level Imaging Diagnosis Center, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan(2).
Eur J Radiol. 2014 Jul;83(7):1157-1162. doi: 10.1016/j.ejrad.2014.02.027. Epub 2014 Mar 29.
The purpose of this study was to compare the diagnostic accuracies of CT and MR imaging for the detection of metastatic retropharyngeal lymph nodes (RLNs) in patients with nasopharyngeal and oropharyngeal squamous cell carcinoma (SCC).
The study included 38 patients (28 men and 10 women; mean age, 65 years; age range, 48-82 years) with nasopharyngeal (n=15) and oropharyngeal (n=23) SCC who underwent both contrast-enhanced CT and MR imaging before chemoradiotherapy. RLNs were classified as malignant or benign on the basis of the results of follow-up MR imaging. Two radiologists independently evaluated the images for diagnosing metastatic RLNs.
Among a total of 68 RLNs (minimum diameter, ≥ 4 mm) that were detected on gadolinium-enhanced fat-suppressed T1-weighted images, 30 (44%) were malignant and 38 (56%) were benign. The sensitivities of CT versus MRI were 60% versus 97% for observer 1 (p<0.01) and 37% versus 90% for observer 2 (p<0.01). The specificities of CT versus MRI were 92% versus 97% for observer 1 (p=0.50) and 92% versus 100% for observer 2 (p=0.25). The areas under the receiver operating characteristic curve (AUC) for CT versus MRI were 0.788 versus 0.996 for observer 1 (p<0.01) and 0.693 versus 0.961 for observer 2 (p<0.01).
MR imaging was superior to CT for the detection of metastatic RLNs.
本研究旨在比较CT和磁共振成像（MR）对鼻咽癌和口咽鳞状细胞癌（SCC）患者咽后转移性淋巴结（RLN）的诊断准确性。
本研究纳入38例患者（28例男性，10例女性；平均年龄65岁；年龄范围48 - 82岁），患有鼻咽癌（n = 15）和口咽癌（n = 23）的SCC，在放化疗前均接受了对比增强CT和MR成像检查。根据后续MR成像结果将RLN分为恶性或良性。两名放射科医生独立评估图像以诊断转移性RLN。
在钆增强脂肪抑制T1加权图像上共检测到68个RLN（最小直径≥4 mm），其中30个（44%）为恶性，38个（56%）为良性。观察者1对CT与MRI的敏感性分别为60%和97%（p<0.01），观察者2分别为37%和90%（p<0.01）。观察者1对CT与MRI的特异性分别为92%和97%（p = 0.50），观察者2分别为92%和100%（p = 0.25）。观察者1对CT与MRI的受试者操作特征曲线（AUC）下面积分别为0.788和0.996（p<0.01），观察者2分别为0.693和0.961（p<0.01）。
在检测转移性RLN方面，MR成像优于CT。
