Scientific Sessions 1–2
نویسندگان
چکیده
Aim : To evaluate diffusion-weighted magnetic resonance imaging (DW-MRI) for detection of regional nodal metastases in primary head and neck squamous cell carcinoma (HNSCC). Materials and methods : Ten patients with HNSCC underwent an MRI prior to surgery. The scan protocol consisted of plain transverse T1and T2-weighted turbo spin echo (TSE) sequences and gadolinium-enhanced transverse, coronal and sagittal T1-weighted TSE sequences. Additionally, a transverse echo-planar DW-MRI sequence, using six b-values between 0 and 1000 s/mm2, was performed. Apparent diffusion coefficient (ADC) maps were calculated for the entire b-value range (ADCavg) and for the high b-values separately (b ≥ 500 s/mm2, ADChigh). ADC values were compared with histopathology of the neck dissection specimens. After determining an optimal threshold for ADCavg and ADChigh, sensitivity and specificity was calculated. Finally DW-MRI was compared with TSE-MRI for detection of nodal metastases. Results : MRI showed 55 lymph nodes; 41 were benign and 14 malignant on histopathology. The mean ADCavg value for benign lymph nodes was 0.00122 ± 0.00029 mm2/s and 0.00090 ± 0.00014 mm2/s for malignant nodes (p < 0.0001), resulting in a sensitivity of 73% and specificity of 83%. The mean ADChigh value for benign lymph nodes was 0.00099 ± 0.00026 mm 2/s and 0.00062± 0.00013 mm2/s for malignant nodes (p < 0.0001), resulting in a sensitivity of 93% and specificity of 83%. TSE-MRI yielded a sensitivity of 57% and specificity of 90%. DW-MRI allowed for additional detection of contralateral adenopathies in three patients and excluded metastasis in a single enlarged lymph node in two different patients. Conclusion : In HNSCC, DW-MRI allows better differentiation of benign and malignant lymph nodes than conventional TSE sequences.
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