Characterization of mediastinal lymphadenopathy with diffusion-weighted imaging.

Autor: Abdel Razek AA; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, 3551 Mansoura, Egypt. arazek@mans.eun.eg, Elkammary S, Elmorsy AS, Elshafey M, Elhadedy T
Jazyk: angličtina
Zdroj: Magnetic resonance imaging [Magn Reson Imaging] 2011 Feb; Vol. 29 (2), pp. 167-72. Date of Electronic Publication: 2010 Oct 15.
DOI: 10.1016/j.mri.2010.08.002
Abstrakt: Purpose: To predict malignancy of mediastinal lymphadenopathy with diffusion-weighted imaging.
Material and Methods: A prospective study was conducted on 35 patients with mediastinal lymphadenopathy (28 malignant and seven benign nodes). They underwent echoplanar diffusion-weighted magnetic resonance imaging of the mediastinum with b-factors of 0, 300 and 600 s/mm(2). The apparent diffusion coefficient (ADC) values of the mediastinal lymph nodes were calculated. The ADC values were correlated with the biopsy results and statistical analysis was done. A value of P<.05 was considered significant.
Results: The mean ADC value of malignant mediastinal lymphadenopathy (1.06±0.3×10(-3) mm(2)/s) was significantly lower (P=.001) than that of benign lymphadenopathy (2.39±0.7×10(-3) mm(2)/s). There was an insignificant difference in the ADC values between metastatic and lymphomatous mediastinal lymph nodes (P=.32) as well as within benign nodes (P=.07). When an ADC value of 1.85×10(-3) mm(2)/s was used as a threshold value for differentiating malignant mediastinal nodes from benign nodes, the best results were obtained with an accuracy of 83.9%, a sensitivity of 96.4%, a specificity of 71.4%, a negative predictive value of 95.2% and a positive predictive value of 77.1%. The area under the curve was 0.98.
Conclusion: Diffusion weighted magnetic resonance imaging is a promising noninvasive imaging modality that can be used for characterization of mediastinal lymphadenopathy and differentiation of malignant from benign mediastinal lymph nodes.
(Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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