Laboratory of Biomedical Engineering for Cancer, Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.
Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, 4-1 Seiryo, Aoba, Sendai, Miyagi, 980-8575, Japan.
Clin Exp Metastasis. 2022 Jun;39(3):421-431. doi: 10.1007/s10585-022-10147-w. Epub 2022 Feb 4.
A perfusion defect (PD) in non-enlarged lymph nodes (LNs) of oral squamous cell carcinoma (OSCC) is the most reliable radiological criterion for the diagnosis of metastasis. However, conventional contrast-enhanced (CE) T1 weighted images using turbo spin echo (TSE) sequence is limited in detecting PD in non-enlarged LNs due to flow artifacts from cervical blood vessels. Vessel wall (VW) MR imaging with blood vessel flow suppression and high spatial resolution may provide new insights into the detection of PD. However, there are no reports in the literature on the usefulness of VW MR imaging for the diagnosis of LN metastasis. It is demonstrated that PD of non-enlarged LNs in CE VR MR imaging of OSCC patients is useful for the diagnosis of metastatic LNs. VW MR imaging was significantly more sensitive in detecting PD of non-enlarged metastatic LNs than conventional TSE imaging on visual evaluation. Furthermore, it was found that the image contrast between PD and surrounding intranodal tissue in CE VW MR images was higher than that in conventional CE TSE images. In the correlation between imaging and histopathological findings of metastatic LNs, all LNs that exhibited PD on CE VW MR images were at an advanced histopathological metastatic stage. The pathology of PD was necrotic tissue with keratinization. The results indicated that PD in CE VW imaging is useful in diagnosing non-enlarged LNs at an advanced metastasis stage. The addition of VW MR imaging to conventional MR examination achieves higher diagnostic performance for non-enlarged metastatic LNs.
在口腔鳞状细胞癌（OSCC）中，非肿大淋巴结（LNs）的灌注缺损（PD）是转移的最可靠的影像学标准。然而，由于颈部血管的流动伪影，使用涡轮自旋回波（TSE）序列的常规对比增强（CE）T1 加权图像在检测非肿大 LNs 的 PD 方面受到限制。具有血管壁（VW）MR 成像和血流抑制及高空间分辨率的技术可能为 PD 的检测提供新的见解。然而，目前尚无文献报道 VW MR 成像在诊断 LN 转移中的应用价值。已经证明，CE VR MR 成像中 OSCC 患者的非肿大 LNs 的 PD 对于转移性 LNs 的诊断是有用的。在视觉评估中，VW MR 成像在检测非肿大转移性 LNs 的 PD 方面比常规 TSE 成像更敏感。此外，发现 CE VW MR 图像中 PD 与周围淋巴结内组织之间的图像对比度高于常规 CE TSE 图像。在转移性 LNs 的影像学和组织病理学发现之间的相关性中，CE VW MR 图像上显示 PD 的所有 LNs 在组织病理学上都处于晚期转移阶段。PD 的病理学是伴有角化的坏死组织。结果表明，CE VW 成像中的 PD 可用于诊断处于晚期转移阶段的非肿大 LNs。将 VW MR 成像添加到常规 MR 检查中，可提高对非肿大转移性 LNs 的诊断性能。
