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扩散加权磁共振成像对于鉴别患有头颈部疾病的犬类患者的局部淋巴结是一种可行的方法。

Diffusion weighted magnetic resonance imaging is a feasible method for characterizing regional lymph nodes in canine patients with head and neck disease.

作者信息

Stahle Jessica A, Larson Martha M, Rossmeisl John H, Dervisis Nick, Neelis Dana

机构信息

Department of Radiology, Red Bank Veterinary Hospital, Mount Laurel, NJ, 08054.

Small Animal Clinical Sciences, Virginia Polytechnic and State University, Blacksburg, VA, 24061.

出版信息

Vet Radiol Ultrasound. 2019 Mar;60(2):176-183. doi: 10.1111/vru.12694. Epub 2018 Nov 12.

Abstract

In dogs diagnosed with solid tumors, regional lymph node involvement or evidence of distant metastasis can predict worse prognoses and significantly decreased survival. Lymph node size alone has been shown to be insufficient as a predictor for the accurate clinical staging of some canine neoplasia. However, certain regional lymph nodes (including those of the oral cavity) are difficult to access for routine tissue sampling. Diffusion weighted magnetic resonance imaging (MRI) has demonstrated the ability to differentiate metastatic from inflammatory/benign lymph nodes in clinical studies with human cancer patients through the calculation of quantitative values of diffusion termed apparent diffusion coefficients (ADC). The objective of this prospective, exploratory study was to evaluate diffusion-weighted MRI and ADC as potential methods for detecting metastatic lymph nodes in dogs with naturally occurring disease. We hypothesized that diffusion-weighted MRI would identify significantly different ADC values between benign and metastatic lymph nodes in a group of canine patients with head or neck disease. Our study population consisted of eight client-owned canine patients, with a total of 20 lymph nodes evaluated (six metastatic, 14 benign). Our results demonstrated that two of four observers identified a significant difference between the mean ADC values of the benign and metastatic lymph nodes. When data from all four observers were pooled, the difference between the mean apparent diffusion coefficients values of the benign and metastatic lymph nodes did not reach significance (P-value = 0.0566). Findings indicated that diffusion-weighted MRI is a feasible method for further characterizing enlarged lymph nodes in dogs with head and neck disease, however measured ADC values did not differ for benign vs. metastatic lymph nodes in this small sample of dogs.

摘要

在被诊断患有实体瘤的犬类中,区域淋巴结受累或远处转移的证据可预示预后较差且生存期显著缩短。单独的淋巴结大小已被证明不足以作为某些犬类肿瘤准确临床分期的预测指标。然而,某些区域淋巴结(包括口腔淋巴结)难以进行常规组织采样。在针对人类癌症患者的临床研究中,扩散加权磁共振成像(MRI)已证明能够通过计算称为表观扩散系数(ADC)的扩散定量值来区分转移性淋巴结与炎性/良性淋巴结。这项前瞻性探索性研究的目的是评估扩散加权MRI和ADC作为检测患有自然疾病犬类转移性淋巴结的潜在方法。我们假设扩散加权MRI能够在一组患有头颈部疾病的犬类患者中识别出良性和转移性淋巴结之间显著不同的ADC值。我们的研究对象包括8只客户拥有的犬类患者,共评估了20个淋巴结(6个转移性,14个良性)。我们的结果表明,四位观察者中有两位识别出良性和转移性淋巴结的平均ADC值之间存在显著差异。当汇总所有四位观察者的数据时,良性和转移性淋巴结的平均表观扩散系数值之间的差异未达到显著水平(P值 = 0.0566)。研究结果表明,扩散加权MRI是进一步表征患有头颈部疾病犬类肿大淋巴结的一种可行方法,然而,在这一小群犬类中,良性与转移性淋巴结的测量ADC值并无差异。

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