正常淋巴结的全身扩散加权 MRI：前瞻性表观扩散系数直方图和健康队列中淋巴结分布分析。
Whole-body diffusion-weighted MRI of normal lymph nodes: prospective apparent diffusion coefficient histogram and nodal distribution analysis in a healthy cohort.
机构信息
Department of Diagnostic Radiolog, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton, London, Surrey, SM2 5PT, UK.
Department of Diagnostic Radiology, Changi General Hospital, 2 Simei St 3, Singapore, 529889, Singapore.
出版信息
Cancer Imaging. 2021 Nov 27;21(1):64. doi: 10.1186/s40644-021-00432-4.
BACKGROUND
Whole body DWI (WB-DWI) enables the identification of lymph nodes for disease evaluation. However, quantitative data of benign lymph nodes across the body are lacking to allow meaningful comparison of diseased states. We evaluated apparent diffusion coefficient (ADC) histogram parameters of all visible lymph nodes in healthy volunteers on WB-DWI and compared differences in nodal ADC values between anatomical regions.
METHODS
WB-DWI was performed on a 1.5 T MR system in 20 healthy volunteers (7 female, 13 male, mean age 35 years). The b900 images were evaluated by two radiologists and all visible nodes from the neck to groin areas were segmented and individual nodal median ADC recorded. All segmented nodes in a patient were summated to generate the total nodal volume. Descriptors of the global ADC histogram, derived from individual node median ADCs, including mean, median, skewness and kurtosis were obtained for the global volume and each nodal region per patient. ADC values between nodal regions were compared using one-way ANOVA with Bonferroni post hoc tests and a p-value ≤0.05 was deemed statistically significant.
RESULTS
One thousand sixty-seven lymph nodes were analyzed. The global mean and median ADC of all lymph nodes were 1.12 ± 0.27 (10 mm/s) and 1.09 (10 mm/s). The average median ADC skewness was 0.25 ± 0.02 and average median ADC kurtosis was 0.34 ± 0.04. The ADC values of intrathoracic, portal and retroperitoneal nodes were significantly higher (1.53 × 10, 1.75 × 10 and 1.58 × 10 mm/s respectively) than in other regions. Intrathoracic, portal and mesenteric nodes were relatively uncommon, accounting for only 3% of the total nodes segmented.
CONCLUSIONS
The global mean and median ADC of all lymph nodes were 1.12 ± 0.27 (10 mm/s) and 1.09 (10 mm/s). Intrathoracic, portal and retroperitoneal nodes display significantly higher ADCs. Normal intrathoracic, portal and mesenteric nodes are infrequently visualized on WB-DWI of healthy individuals.
TRIAL REGISTRATION
Royal Marsden Hospital committee for clinical research registration number 09/H0801/86, 19.10.2009.
背景
全身弥散加权成像（WB-DWI）可用于识别淋巴结以进行疾病评估。然而，由于缺乏全身良性淋巴结的定量数据，因此无法对疾病状态进行有意义的比较。我们评估了健康志愿者在 WB-DWI 上所有可见淋巴结的表观扩散系数（ADC）直方图参数，并比较了解剖区域之间淋巴结 ADC 值的差异。
方法
在 1.5TMR 系统上对 20 名健康志愿者（7 名女性，13 名男性，平均年龄 35 岁）进行了 WB-DWI。两名放射科医生评估了 b900 图像，并对颈部至腹股沟区域的所有可见淋巴结进行了分割，并记录了每个淋巴结的中位数 ADC。对每位患者的所有分割淋巴结进行求和，以生成总淋巴结体积。从每个淋巴结的中位数 ADC 中得出用于总体积和每个淋巴结区域的全局 ADC 直方图描述符，包括均值、中位数、偏度和峰度。使用单因素方差分析和 Bonferroni 事后检验比较淋巴结区域之间的 ADC 值，p 值≤0.05 被认为具有统计学意义。
结果
共分析了 1067 个淋巴结。所有淋巴结的全局平均和中位数 ADC 分别为 1.12±0.27（10mm/s）和 1.09（10mm/s）。平均中位数 ADC 偏度为 0.25±0.02，平均中位数 ADC 峰度为 0.34±0.04。胸腔内、门静脉和腹膜后淋巴结的 ADC 值明显较高（分别为 1.53×10、1.75×10 和 1.58×10mm/s）。胸腔内、门静脉和肠系膜淋巴结相对少见，仅占分割淋巴结的 3%。
结论
所有淋巴结的全局平均和中位数 ADC 分别为 1.12±0.27（10mm/s）和 1.09（10mm/s）。胸腔内、门静脉和腹膜后淋巴结显示出明显更高的 ADC 值。正常的胸腔内、门静脉和肠系膜淋巴结在健康个体的 WB-DWI 中很少见到。
试验注册
皇家马斯登医院临床研究注册委员会登记号 09/H0801/86，2009 年 10 月 19 日。
Zotero 插件