Curtin H D, Ishwaran H, Mancuso A A, Dalley R W, Caudry D J, McNeil B J
Department of Radiology, Massachusetts Eye and Ear Infirmary, Boston 02114, USA.
Radiology. 1998 Apr;207(1):123-30. doi: 10.1148/radiology.207.1.9530307.
To compare the abilities of magnetic resonance (MR) imaging and computed tomography (CT) in detection of lymph node metastasis from head and neck squamous cell carcinoma.
MR imaging and CT were performed with standard protocols in patients with known carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx. Histopathologic examination was performed to validate imaging findings. Between 1991 and 1994, 213 patients undergoing 311 neck dissections were accrued at three institutions.
For the upper jugular and spinal accessory regions, the areas under the receiver operating characteristic curves for combined information on size and internal abnormality were 0.80 for CT and 0.75 for MR imaging. Sensitivities, specificities, negative predictive values (NPVs), and positive predictive values (PPVs) were calculated for various size criteria with and without internal abnormality information. With use of a 1-cm size or an internal abnormality to indicate a positive node, CT had an NPV of 84% and a PPV of 50%, and MR imaging had an NPV of 79% and a PPV of 52%. CT achieved an NPV of 90%, correlating with a PPV of 44%, with use of 5-mm size as an indicator of a positive node.
CT performed slightly better than MR imaging for all interpretative criteria. However, a high NPV was achieved only when a low size criterion was used and was therefore associated with a relatively low PPV.
比较磁共振成像（MR）和计算机断层扫描（CT）检测头颈部鳞状细胞癌淋巴结转移的能力。
对已知患有口腔、口咽、下咽或喉癌的患者采用标准方案进行MR成像和CT检查。进行组织病理学检查以验证影像学结果。1991年至1994年期间，在三个机构共纳入了213例接受311次颈部清扫术的患者。
对于上颈静脉和副神经区域，综合大小和内部异常信息的受试者操作特征曲线下面积，CT为0.80，MR成像为0.75。针对有无内部异常信息的各种大小标准计算了敏感度、特异度、阴性预测值（NPV）和阳性预测值（PPV）。使用1厘米大小或内部异常来指示阳性淋巴结时，CT的NPV为84%，PPV为50%，MR成像的NPV为79%，PPV为52%。以5毫米大小作为阳性淋巴结的指标时，CT的NPV为90%，对应的PPV为44%。
对于所有解释标准，CT的表现略优于MR成像。然而，只有使用低大小标准时才能实现高NPV，因此与相对较低的PPV相关。
