在在子宫的癌症的淋巴节点转移的评估的 DWI 和 PET/CT 的比较

• 作者: Erena Yamasaki Kazuhiro Kitajima Kazuro Sugimura Koji Murakami Yasushi Kaji
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: UTERINE cancer LYMPH node metastasis Magnetic resonance IMAGING Diffusion-weighed IMAGING POSITRON emission TOMOGRAPHY and COMPUTED TOMOGRAPHY
• 年，卷（期）: 2012,（5）
• 页码范围: 207-214
• 页数: 8页
• 分类号: R737.33

摘要

AIM: To investigate diffusion-weighted imaging (DWI) and positron emission tomography and computed tomography (PET/CT) with Ⅳ contrast for the preoperative evaluation of pelvic lymph node (LN) metastasis in uterine cancer. METHODS: Twenty-five patients with endometrial or cervical cancer who underwent both DWI and PET/CT before pelvic lymphadenectomy were included in this study. For area specific analysis, LNs were divided into eight regions: both common iliac, external iliac, internal iliac areas, and obturator areas. The classification for malignancy on DWI was a focally abnormal signal intensity in a location that corresponded to the LN chains on the T1WI and T2WI. The criterion for malignancy on PET/CT images was increased tracer uptake by the LN.RESULTS: A total of 36 pathologically positive LN areas were found in 9 patients. With DWI, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detecting metastatic LNs on an LN area-by-area analysis were 83.3%, 51.2%, 27.3%, 93.3% and 57.0%, respectively, while the corresponding values for PET/CT were 38.9%, 96.3%, 70.0%, 87.8% and 86.0%. Differences in sensitivity, specificity and accuracy were significant (P 【 0.0005). CONCLUSION: DWI showed higher sensitivity and lower specificity than PET/CT. Neither DWI nor PET/CT were sufficiently accurate to replace lymphadenectomy.