Department of Radiology, University Medical Center Regensburg, 93053 Regensburg, Germany.
Department of Othorhinolaryngology, Merciful Brothers Hospital St. Elisabeth, 94315 Straubing, Germany.
Tomography. 2022 Oct 9;8(5):2522-2532. doi: 10.3390/tomography8050210.
(1) Background: To determine the importance of diffusion-weighted whole-body MRI with background body signal suppression (DWIBS) in the staging process of patients with suspected head and neck carcinomas. (2) Methods: A total of 30 patients (24 male, 6 female) with a median age of 67 years with clinically suspected head and neck carcinoma with pathologic cervical nodal swelling in ultrasound underwent the staging procedure with computed tomography (CT) and whole-body MRI including DWIBS. (3) Results: In a total of 9 patients, abnormalities in the routine work-up of pretherapeutic staging were found. Five cases of either secondary cancer or distant metastases were only visible in DWIBS, while being missed on CT. One diagnosis was only detectable in CT and not in DWIBS, whereas three diagnoses were recognizable in both modalities. (4) Conclusions: DWIBS in addition to a standard neck MRI in cervical lymphadenopathy suspicious for head and neck cancer yielded additional clinically relevant diagnoses in 17% of cases that would have been missed by current staging routine procedures. DWIBS offered a negative predictive value of 98.78% for ruling out distant metastases or secondary malignancies.
(1) 背景：确定背景抑制弥散加权全身 MRI（DWIBS）在疑似头颈部癌患者分期过程中的重要性。(2) 方法：共 30 例（24 例男性，6 例女性）患者，中位年龄 67 岁，临床怀疑头颈部癌，超声检查发现颈部淋巴结病理性肿大，行 CT 和全身 MRI 检查，包括 DWIBS。(3) 结果：在总共 9 例患者中，在治疗前分期的常规检查中发现了异常。5 例继发性癌症或远处转移仅在 DWIBS 中可见，而在 CT 上漏诊。1 例诊断仅在 CT 上可见，而在 DWIBS 上不可见，而 3 例诊断在两种方式下均可见。(4) 结论：在疑似头颈部癌的颈部淋巴结病患者中，DWIBS 联合标准颈部 MRI 检查可在 17%的病例中提供额外的临床相关诊断，这些诊断会被当前的分期常规检查遗漏。DWIBS 对排除远处转移或继发性恶性肿瘤的阴性预测值为 98.78%。
