磁共振淋巴造影术用于口腔癌患者前哨淋巴结检测的初步临床研究。
MR lymphography for sentinel lymph node detection in patients with oral cavity cancer: Preliminary clinical study.
作者信息
Bae Sohi, Lee Ho-Joon, Nam Woong, Koh Yoon Woo, Choi Eun Chang, Kim Jinna
机构信息
Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Oral and Maxillofacial Surgery, Dental Hospital of Yonsei University of College of Dentistry, Seoul, Korea.
出版信息
Head Neck. 2018 Jul;40(7):1483-1488. doi: 10.1002/hed.25167. Epub 2018 Apr 6.
BACKGROUND
The purpose of this study was to evaluate the feasibility of MR lymphography with interstitial injection of a gadolinium-based contrast agent for identifying sentinel lymph nodes in patients with oral cavity cancer and clinically negative neck.
METHODS
Pretreatment MR lymphography with a differential subsampling with cartesian ordering (DISCO) sequence was performed in 26 patients with resectable oral cavity cancer and clinically negative neck, after peritumoral injection of 1-mL diluted gadobutrol. The accuracy of sentinel lymph node identification by MR lymphography was assessed and compared with the final histopathological results.
RESULTS
The MR lymphography consistently visualized the 44 sentinel lymph nodes in all 26 patients. In all but 1 patient with pathologically positive neck, assumed sentinel lymph nodes revealed metastatic involvement.
CONCLUSION
Pretreatment MR lymphography is a safe and feasible imaging technique that can help clinicians identify sentinel lymph nodes with a high risk of occult metastases in patients with oral cavity cancer, enabling focused preoperative biopsy in these high-risk patients.
背景
本研究的目的是评估经间质注射钆基造影剂的磁共振淋巴造影术在识别口腔癌且颈部临床阴性患者前哨淋巴结方面的可行性。
方法
对26例可切除的口腔癌且颈部临床阴性患者，在瘤周注射1 mL稀释的钆布醇后，采用笛卡尔排序的差分采样（DISCO）序列进行预处理磁共振淋巴造影。评估磁共振淋巴造影识别前哨淋巴结的准确性，并与最终的组织病理学结果进行比较。
结果
磁共振淋巴造影在所有26例患者中均清晰显示了44个前哨淋巴结。除1例颈部病理阳性患者外，其余假定的前哨淋巴结均显示有转移累及。
结论
预处理磁共振淋巴造影是一种安全可行的成像技术，可帮助临床医生识别口腔癌患者中存在隐匿转移高风险的前哨淋巴结，从而使这些高风险患者能够进行有针对性的术前活检。
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