Ando Tomohiro, Kato Hiroki, Kawaguchi Masaya, Tanahashi Yukichi, Aoki Mitsuhiro, Kuze Bunya, Matsuo Masayuki
Gifu University School of Medicine, Japan.
Pol J Radiol. 2020 Jan 6;85:e1-e7. doi: 10.5114/pjr.2020.92668. eCollection 2020.
To evaluate the significance of additional coronal reconstruction images in the diagnostic ability of contrast-enhanced computed tomography (CECT) for metastatic cervical nodes in patients with head and neck squamous cell carcinomas (HNSCC).
We retrospectively assessed 97 metastatic and 141 reactive histologically proven cervical nodes of 38 patients with HNSCC, who underwent CECT before neck dissection. Observer #1, an expert radiologist in head and neck imaging, and observer #2, a general radiologist, reviewed all CECT images. The observers first assessed the presence of nodal metastasis using axial CECT alone (A-CECT). Three days later, they reassessed its presence using combined axial and coronal CECT (A&C-CECT).
The sensitivity of A-CECT vs. A&C-CECT was 73.2% vs. 75.3% for observer #1 ( = 0.73) and 69.1% vs. 69.1% for observer #2 ( = 1.00), respectively. The specificity of A-CECT versus A&C-CECT was 92.2% vs. 97.2% for observer #1 ( < 0.05) and 92.9% vs. 95.7% for observer #2 ( = 0.22), respectively. The accuracy of A-CECT versus A&C-CECT was 84.5% vs. 88.2% for observer #1 ( < 0.05) and 83.2% vs. 85.3% for observer #2 ( = 0.30), respectively. The area under the curve (AUC) of A-CECT vs. A&C-CECT was 0.86 vs. 0.91 for observer #1 ( < 0.05) and 0.85 vs. 0.85 for observer #2 ( = 0.80), respectively.
The specificity, accuracy, and AUC increased with the use of coronal images during the assessment by the expert radiologist. The appropriate use of coronal images allowed proper configuration recognition and improved diagnostic ability.
评估额外的冠状位重建图像在头颈部鳞状细胞癌（HNSCC）患者转移性颈部淋巴结的增强计算机断层扫描（CECT）诊断能力中的意义。
我们回顾性评估了38例接受颈部清扫术前CECT检查的HNSCC患者的97个经组织学证实的转移性颈部淋巴结和141个反应性颈部淋巴结。观察者1是一位头颈影像学专家放射科医生，观察者2是一位普通放射科医生，他们对所有CECT图像进行了评估。观察者首先仅使用轴向CECT（A-CECT）评估淋巴结转移的存在情况。三天后，他们使用轴向和冠状位联合CECT（A&C-CECT）重新评估其存在情况。
观察者1中，A-CECT与A&C-CECT的敏感性分别为73.2%和75.3%（P = 0.73），观察者2中分别为69.1%和69.1%（P = 1.00）。观察者1中，A-CECT与A&C-CECT的特异性分别为92.2%和97.2%（P < 0.05），观察者2中分别为92.9%和95.7%（P = 0.22）。观察者1中，A-CECT与A&C-CECT的准确性分别为84.5%和88.2%（P < 0.05），观察者2中分别为83.2%和85.3%（P = 0.30）。观察者1中，A-CECT与A&C-CECT的曲线下面积（AUC）分别为0.86和0.91（P < 0.05），观察者2中分别为0.85和0.85（P = 0.80）。
在专家放射科医生的评估过程中，使用冠状位图像可提高特异性、准确性和AUC。冠状位图像的合理使用有助于正确识别形态并提高诊断能力。
