Cho Pyeonghwa, Park Chang Suk, Park Ga Eun, Kim Sung Hun, Kim Hyeon Sook, Oh Se-Jeong
Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea School of Medicine, Seoul 21431, Republic of Korea.
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea School of Medicine, Seoul 06591, Republic of Korea.
Diagnostics (Basel). 2023 Jan 31;13(3):513. doi: 10.3390/diagnostics13030513.
This study aimed to determine whether apparent diffusion coefficient (ADC) and morphological features on diffusion-weighted MRI (DW-MRI) can discriminate metastatic axillary lymph nodes (ALNs) from benign in patients with breast cancer. Two radiologists measured ADC, long and short diameters, long-to-short diameter ratio, and cortical thickness and assessed eccentric cortical thickening, loss of fatty hilum, irregular margin, asymmetry in shape or number, and rim sign of ALNs on DW-MRI and categorized them into benign or suspicious ALNs. Pathologic reports were used as a reference standard. Statistical analysis was performed using the Mann-Whitney U test and chi-square test. Overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of DW-MRI were calculated. The ADC of metastatic ALNs was 0.905 × 10 mm/s, and that of benign ALNs was 0.991 × 10 mm/s ( = 0.243). All morphologic features showed significant difference between the two groups. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the final categorization on DW-MRI were 77.1%, 93.3%, 79.4%, 92.5%, and 86.2%, respectively. Our results suggest that morphologic evaluation of ALNs on DWI can discriminate metastatic ALNs from benign. The ADC value of metastatic ALNs was lower than that of benign nodes, but the difference was not statistically significant.
本研究旨在确定扩散加权磁共振成像（DW-MRI）上的表观扩散系数（ADC）和形态特征能否区分乳腺癌患者腋窝转移性淋巴结（ALNs）与良性淋巴结。两名放射科医生测量了ADC、长短径、长短径比以及皮质厚度，并评估了DW-MRI上ALNs的偏心皮质增厚、脂肪门缺失、边缘不规则、形状或数量不对称以及边缘征，并将它们分类为良性或可疑ALNs。病理报告用作参考标准。采用曼-惠特尼U检验和卡方检验进行统计分析。计算了DW-MRI的总体敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和诊断准确性。转移性ALNs的ADC为0.905×10⁻³mm²/s，良性ALNs的ADC为0.991×10⁻³mm²/s（P = 0.243）。所有形态特征在两组之间均显示出显著差异。DW-MRI最终分类的敏感性、特异性、PPV、NPV和诊断准确性分别为77.1%、93.3%、79.4%、92.5%和86.2%。我们的结果表明，DWI上对ALNs的形态学评估可以区分转移性ALNs与良性淋巴结。转移性ALNs的ADC值低于良性淋巴结，但差异无统计学意义。
