摘要
目的:对比小视野弥散加权成像(reduced field-of-view diffusion-weighted imaging,rFOV-DWI)与常规视野弥散加权成像(full field-of-view diffusion-weighted imaging,fFOV-DWI)在诊断头颈部肿瘤转移性颈部淋巴结中的应用价值。方法:回顾性分析80例伴有颈部淋巴结转移的头颈部肿瘤的患者资料。患者在治疗前均行rFOV-DWI和fFOV-DWI检查。2名影像诊断医师采用双盲法对DWI图像的整体图像质量、清晰度、视觉变形和伪影进行主观评分。计算并比较两组DWI图像的信噪比(signal-to-noise ratio,SNR)、对比噪声比(contrast-to-noise ratio,CNR)。以T2加权成像(T2-weighted imaging,T2WI)横断位图像为参考,测量并比较弥散加权成像(diffusion-weighted imaging,DWI)图像中反映淋巴结对准精度的客观指标[前后径(anteroposterior diameters,AP);左右径(left-right diameters,LR);面积(Area);变形率(distortion rate,DR)]。分析两组的表观弥散系数(apparent diffusion coefficient,ADC)、敏感性和特异性,并绘制ROC曲线预测恶性淋巴结。结果:诊断医师的主观评分一致性良好(组内相关系数值均>0.7)。rFOV-DWI的整体图像质量、伪影和视觉变形三项评分均明显高于fFOV-DWI,差异有统计学意义(均P<0.05),而清晰度方面的差异无统计学意义(P=0.296)。rFOV-DWI图像的SNR和CNR显著高于fFOV-DWI图像,差异有统计学意义(SNR:21.12±13.35 vs 12.85±6.70;CNR:18.43±11.95 vs 11.83±6.37;均P<0.05)。淋巴结在rFOV-DWI与T2WI图像匹配的对准精准度(AP:P=0.330;LR:P=0.088;Area:P=0.060;DR:P=0.079)高于fFOV-DWI与T2WI匹配的对准精准度(AP:P<0.001;LR:P<0.001;Area:P=0.003;DR:P=0.015)。rFOV-DWI测出的淋巴结ADC值低于fFOV-DWI(t=-2.491,P=0.014)。两者诊断性能方面的差异无统计学意义(AUC:0.977与0.920;特异性:0.833与0.833;敏感性:0.931与0.959;均P>0.05)。结论:在颈部淋巴结DWI检查中,两种弥散技术对转移性颈部淋巴结的诊断性能相当,rFOV-DWI较fFOV-DWI能提高图像的质量,清晰地显示病变,为临床诊断提供更可靠的影像资料。
Objective:To compare the efficacy of reduced field-of-view diffusion-weighted imaging(rFOV-DWI)versus full field-of-view diffusion-weighted imaging(fFOV-DWI)for detecting metastatic cervical lymph nodes in head and neck cancer.Methods:Imaging data from 80 patients with metastatic cervical lymph nodes due to head and neck cancer were retrospectively analyzed.All patients underwent rFOV-DWI and fFOV-DWI before treatment.Two radiologists inde-pendently evaluated diffusion-weighted imaging(DWI)images in a blinded manner for subjective assessment of overall image quality,sharpness,visual distortion,and artifacts.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were quantitatively compared between rFOV-DWI and fFOV-DWI.Using transverse T2-weighted imaging(T2WI)as the anatomi-cal reference,objective metrics reflecting alignment accuracy of lymph nodes on DWI were measured and compared:anteroposterior diameter(AP),left-right diameter(LR),area,and distortion rate(DR).Apparent diffusion coefficient(ADC)values were analyzed,and the sensitivity and specificity were compared between the two groups.Receiver operating characteristic curves were generated to predict malignancy.Results:Interobserver agreement between the two radiologists was excellent,with all intraclass correlation coefficients exceeding 0.7.rFOV-DWI demonstrated significantly higher subjective scores than fFOV-DWI in overall image quality,artifacts,and visual distortion(all P<0.05),while no significant difference was observed in sharpness(P=0.296).Significantly higher SNR and CNR values were observed in rFOV-DWI compared to fFOV-DWI(SNR:21.12±13.35 vs 12.85±6.70,CNR:18.43±11.95 vs 11.83±6.37,all P<0.05).Lymph node alignment accuracy to T2WI was significantly superior with rFOV-DWI,evidenced by non-significant geometric deviations(AP:P=0.330;LR:P=0.088;Area:P=0.060;DR:P=0.079),while fFOV-DWI showed significant mismatches(AP:P<0.001;LR:P<0.001;Area:P=0.003;DR:P=0.015).Significantly lower ADC values were observed in metastatic lymph nodes with rFOV-DWI compared to fFOV-DWI(t=-2.491,P=0.014).However,both techniques demonstrated compara-ble diagnostic performance,as evidenced by area under the curve(0.977 vs 0.920),specificity(83.3%vs 83.3%),and sensitivity(93.1%vs 95.9%)(all P>0.05).Conclusion:In DWI of cervical lymph nodes,rFOV-DWI and fFOV-DWI demonstrated comparable diagnostic performance for detecting metastatic involvement.However,rFOV-DWI significantly improved image quality,clearly display lesions,and provide more reliable imaging data for clinical diagnosis.
作者
杨帆
易思琪
邓和平
林礼波
何雅坤
Yang Fan;Yi Siqi;Deng Heping;Lin Libo;He Yakun(Department of Radiology,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)
出处
《肿瘤预防与治疗》
2025年第8期696-702,共7页
Journal of Cancer Control And Treatment
基金
四川省科技厅重点研发项目(编号:2023YFS0157)。
关键词
磁共振成像
弥散加权成像
颈部转移性淋巴结
图像质量
表观扩散系数
Magnetic resonance imaging
Dffusion-weighted imaging
Metastatic cervical lymph nodules
Image quality
Apparent diffusion coefficient
