Objective To evaluate the clinical impact of body diffusion weighted imaging (DWI) on the diagnosis and preoperative N staging of cervical cancer. Methods Twenty-four patients (mean age 37.9 years old) with proved cer...Objective To evaluate the clinical impact of body diffusion weighted imaging (DWI) on the diagnosis and preoperative N staging of cervical cancer. Methods Twenty-four patients (mean age 37.9 years old) with proved cervical cancer by cervical biopsy and 24 female patients with other suspected pelvic abnormalities received preoperative body DWI scan. Results of body DWI were compared with pathological findings. The apparent diffusion coefficient (ADC) values of normal cervix and different pathological types of cervical cancer were compared. ADC value of normal or inflammatory lymph nodes was also compared with that of metastatic ones. Student's t test was used for statistical analysis. Results There were 5 adenocarcinomas and 19 epitheliomas showed with biopsy results, and DWI showed 21 cervical lesions out of them (87.5%). ADC values of the normal cervix (n = 24), epithelioma (n = 19), and adenocar- cinoma (n = 5) were (1.73 ± 0.31) ×10-3, (0.88 ± 0.22) ×10-3, and (1.08 ± 0.12) ×10-3 mm2/s, respectively. Statistical analysis showed significant difference in ADC value between normal cervical tissue and either tumor tissues (both P < 0.01). In patients had lymphadenectomy (n = 24), totally 67 lymph nodes including 16 metastatic lymph nodes were pathologically analyzed, and DWI showed 66 (98.5%) out of them. ADC values of normal/inflammatory and metastatic lymph nodes were (1.07 ± 0.16) ×10-3 and (0.77 ± 0.13) ×10-3 mm2/s (P < 0.01). Receiver operating characteristic (ROC) curve of ADC value of metastatic lymph node showed that area under curve was 0.961. Conclusions ADC value in cervical carcinoma is lower than that in normal cervix, and ADC may have predictive value in subtype discrimination. ADC value may improve the preoperative characterization of lymph node metastasis. And at least abdominal and pelvic DWI scan is suggested for N staging evaluation in such patients.展开更多
Objective To evaluate the value of whole-body diffusion weighted imaging （WB-DWI） on detection of malignant metastasis. Methods Forty-six patients with malignant tumors underwent WB-DWI examinations between April 20...Objective To evaluate the value of whole-body diffusion weighted imaging （WB-DWI） on detection of malignant metastasis. Methods Forty-six patients with malignant tumors underwent WB-DWI examinations between April 2007 and August 2007 in our hospital. Before WB-DWI examination, the primary cancers of all the patients were confirmed by pathology, and the TNM-stage was assessed with conventional magnetic resonance imaging （MRI） or computed tomography （CT）. WB-DWI was performed using short TI inversion recovery echo-planar imaging （STIR-EPI） sequence. Abnormal high signal intensities on WB-DWI were considered as metastases. The results of WB-DWI were compared with other imaging modalities. For the assessment of the diagnostic capability of WB-DWI, WB-DWI were compared with CT for demonstrating mediastinal lymph node metastases and lung metastases, and with conventional MRI for demonstrating metastases in other locations. Results WB-DWI demonstrated 143 focuses, 14 routine imaging. The number of bone metastases depicted of which were diagnosed to be benign lesions in on WB-DWI and routine imaging was 85 and 86; lymph node metastases was 17 and 18; liver metastases was 14 and 14; lung metastases was 4 and 8; and brain metastases was 6 and 8, respectively. WB-DWI failed to detect 12 metastatic lesions including 3 osteoplastic bone metastases, 4 lung metastases, 3 mediastinal lymph node metastases, and 2 brain metastases Four metastatic lesions including 2 deltopectoral lymph nodes and 2 rib metastases were detected with WB-DWI alone, all of which evolved greatly during clinical follow-up for more than 6 months. WB-DWI had higher detection rates for metastatic lesions in liver, bone, and lymph nodes than those in lung and brain （ X^2=30, P〈0.001）. Conclusions WB-DWI could detect most of metastatic lesions that were diagnosed with conventional MRI and CT. The limitations of WB-DWI might be had high false-positive rate and low efficiency in detecting mecliastinal lymph node, brain, and lung metastases.展开更多
Objective To investigate the feasibility of magnetic resonance （MR） diffusion weighted imaging （DWI） in discriminating inflammatory from VX2 carcinoma metastatic lymph nodes in rabbit model. Methods Twenty New Ze...Objective To investigate the feasibility of magnetic resonance （MR） diffusion weighted imaging （DWI） in discriminating inflammatory from VX2 carcinoma metastatic lymph nodes in rabbit model. Methods Twenty New Zealand white rabbits were randomly divided into 2 groups. Complete Freund＇s adjuvant was injected into the bilateral dorsal footpads to set up ipsilateral lymphadenitis model （n = 10）, and the other 10 rabbits received a subcutaneous implantation of VX2 tumor cell suspension （1.5×10^7 cells/mL） in both thighs to set up metastatic lymph node model. MR imaging scan covering the popliteal fossa and lilac fossa including short time inversion recovery echo-planar imaging DWI （STIR-EPI-DWI）, Tl-weighted imaging （T1WI） and T2-weighted imaging （T2WI） was performed 2 weeks after injection. T2WI signal intensity （SI）, DWI SI, long/short axial ratio （LSR） and apparent diffusion coefficient （ADC） values of the lymph nodes were evaluated in all cases. Right after MR imaging scan, popliteal and iliac fossa lymph nodes were collected for hematoxylin-eosin staining. Results Totally 33 lymph nodes larger than 5 turn, including 22 inflammatory and 11 metastatic ones, were successfully isolated and taken into pathological analysis. LSR showed no significant difference between the inflammatory and malignant lymph nodes （P 〉 0.05）. Both benign and malignant lymph nodes appeared iso-intense on TlWI and hyperintense on both T2WI and DWI images with an even lower TlWI and higher T2WI SI core at the hilum. Both T2WI and DWI SI showed no significant difference between two pathological groups （P 〉 0.01） in popliteal fossa. The mean ADC value of inflammatory nodes [（1.199±0.281） ×10^-3 mm^2/s] was significantly higher than that of metastatic nodes [（0.858 ± 0.090） ×10^-3 mm^2/s, P 〈 0.01]. On ADC map, a high ADC value central area could be seen in most of the lymph nodes no matter benign or malignant. ADC value gave out the largest area under curve （AUCADC = 0.955） compared with other three indexes （AUCLsR = 0.488; AUCT2WI SI = 0.727; AUCDDWISI = 0.822） and gave the best sensitivity and specificity in lymph node differential diagnosis compared with the other three indexes. Conclusions High quality DWI image can be obtained using STIR-EPI-DWI sequence in rabbit model. DWI is a new promising technique for differentiating inflammatory from metastatic lymph nodes. Compared with routine MR sequence, DWI could provide more useful physiological and functional information for diagnosis.展开更多
Objective To assess the reproducibility of whole-body diffusion weighted imaging(WB-DWI) technique in healthy volunteers under normal breathing with background body signal suppression.Methods WB-DWI was performed on 3...Objective To assess the reproducibility of whole-body diffusion weighted imaging(WB-DWI) technique in healthy volunteers under normal breathing with background body signal suppression.Methods WB-DWI was performed on 32 healthy volunteers twice within two-week period using short TI inversion-recovery diffusion-weighted echo-planar imaging sequence and built-in body coil.The volunteers were scanned across six stations continuously covering the entire body from the head to the feet under normal breathing.The bone apparent diffusion coefficient(ADC) and exponential ADC(eADC) of regions of interest(ROIs) were measured.We analyzed correlation of the results using paired-t-test to assess the reproducibility of the WB-DWI technique.Results We were successful in collecting and analyzing data of 64 WB-DWI images.There was no significant difference in bone ADC and eADC of 824 ROIs between the paired observers and paired scans(P>0.05).Most of the images from all stations were of diagnostic quality.Conclusion The measurements of bone ADC and eADC have good reproducibility.WB-DWI technique under normal breathing with background body signal suppression is adequate.展开更多
文摘Objective To evaluate the clinical impact of body diffusion weighted imaging (DWI) on the diagnosis and preoperative N staging of cervical cancer. Methods Twenty-four patients (mean age 37.9 years old) with proved cervical cancer by cervical biopsy and 24 female patients with other suspected pelvic abnormalities received preoperative body DWI scan. Results of body DWI were compared with pathological findings. The apparent diffusion coefficient (ADC) values of normal cervix and different pathological types of cervical cancer were compared. ADC value of normal or inflammatory lymph nodes was also compared with that of metastatic ones. Student's t test was used for statistical analysis. Results There were 5 adenocarcinomas and 19 epitheliomas showed with biopsy results, and DWI showed 21 cervical lesions out of them (87.5%). ADC values of the normal cervix (n = 24), epithelioma (n = 19), and adenocar- cinoma (n = 5) were (1.73 ± 0.31) ×10-3, (0.88 ± 0.22) ×10-3, and (1.08 ± 0.12) ×10-3 mm2/s, respectively. Statistical analysis showed significant difference in ADC value between normal cervical tissue and either tumor tissues (both P < 0.01). In patients had lymphadenectomy (n = 24), totally 67 lymph nodes including 16 metastatic lymph nodes were pathologically analyzed, and DWI showed 66 (98.5%) out of them. ADC values of normal/inflammatory and metastatic lymph nodes were (1.07 ± 0.16) ×10-3 and (0.77 ± 0.13) ×10-3 mm2/s (P < 0.01). Receiver operating characteristic (ROC) curve of ADC value of metastatic lymph node showed that area under curve was 0.961. Conclusions ADC value in cervical carcinoma is lower than that in normal cervix, and ADC may have predictive value in subtype discrimination. ADC value may improve the preoperative characterization of lymph node metastasis. And at least abdominal and pelvic DWI scan is suggested for N staging evaluation in such patients.
文摘Objective To evaluate the value of whole-body diffusion weighted imaging （WB-DWI） on detection of malignant metastasis. Methods Forty-six patients with malignant tumors underwent WB-DWI examinations between April 2007 and August 2007 in our hospital. Before WB-DWI examination, the primary cancers of all the patients were confirmed by pathology, and the TNM-stage was assessed with conventional magnetic resonance imaging （MRI） or computed tomography （CT）. WB-DWI was performed using short TI inversion recovery echo-planar imaging （STIR-EPI） sequence. Abnormal high signal intensities on WB-DWI were considered as metastases. The results of WB-DWI were compared with other imaging modalities. For the assessment of the diagnostic capability of WB-DWI, WB-DWI were compared with CT for demonstrating mediastinal lymph node metastases and lung metastases, and with conventional MRI for demonstrating metastases in other locations. Results WB-DWI demonstrated 143 focuses, 14 routine imaging. The number of bone metastases depicted of which were diagnosed to be benign lesions in on WB-DWI and routine imaging was 85 and 86; lymph node metastases was 17 and 18; liver metastases was 14 and 14; lung metastases was 4 and 8; and brain metastases was 6 and 8, respectively. WB-DWI failed to detect 12 metastatic lesions including 3 osteoplastic bone metastases, 4 lung metastases, 3 mediastinal lymph node metastases, and 2 brain metastases Four metastatic lesions including 2 deltopectoral lymph nodes and 2 rib metastases were detected with WB-DWI alone, all of which evolved greatly during clinical follow-up for more than 6 months. WB-DWI had higher detection rates for metastatic lesions in liver, bone, and lymph nodes than those in lung and brain （ X^2=30, P〈0.001）. Conclusions WB-DWI could detect most of metastatic lesions that were diagnosed with conventional MRI and CT. The limitations of WB-DWI might be had high false-positive rate and low efficiency in detecting mecliastinal lymph node, brain, and lung metastases.
文摘Objective To investigate the feasibility of magnetic resonance （MR） diffusion weighted imaging （DWI） in discriminating inflammatory from VX2 carcinoma metastatic lymph nodes in rabbit model. Methods Twenty New Zealand white rabbits were randomly divided into 2 groups. Complete Freund＇s adjuvant was injected into the bilateral dorsal footpads to set up ipsilateral lymphadenitis model （n = 10）, and the other 10 rabbits received a subcutaneous implantation of VX2 tumor cell suspension （1.5×10^7 cells/mL） in both thighs to set up metastatic lymph node model. MR imaging scan covering the popliteal fossa and lilac fossa including short time inversion recovery echo-planar imaging DWI （STIR-EPI-DWI）, Tl-weighted imaging （T1WI） and T2-weighted imaging （T2WI） was performed 2 weeks after injection. T2WI signal intensity （SI）, DWI SI, long/short axial ratio （LSR） and apparent diffusion coefficient （ADC） values of the lymph nodes were evaluated in all cases. Right after MR imaging scan, popliteal and iliac fossa lymph nodes were collected for hematoxylin-eosin staining. Results Totally 33 lymph nodes larger than 5 turn, including 22 inflammatory and 11 metastatic ones, were successfully isolated and taken into pathological analysis. LSR showed no significant difference between the inflammatory and malignant lymph nodes （P 〉 0.05）. Both benign and malignant lymph nodes appeared iso-intense on TlWI and hyperintense on both T2WI and DWI images with an even lower TlWI and higher T2WI SI core at the hilum. Both T2WI and DWI SI showed no significant difference between two pathological groups （P 〉 0.01） in popliteal fossa. The mean ADC value of inflammatory nodes [（1.199±0.281） ×10^-3 mm^2/s] was significantly higher than that of metastatic nodes [（0.858 ± 0.090） ×10^-3 mm^2/s, P 〈 0.01]. On ADC map, a high ADC value central area could be seen in most of the lymph nodes no matter benign or malignant. ADC value gave out the largest area under curve （AUCADC = 0.955） compared with other three indexes （AUCLsR = 0.488; AUCT2WI SI = 0.727; AUCDDWISI = 0.822） and gave the best sensitivity and specificity in lymph node differential diagnosis compared with the other three indexes. Conclusions High quality DWI image can be obtained using STIR-EPI-DWI sequence in rabbit model. DWI is a new promising technique for differentiating inflammatory from metastatic lymph nodes. Compared with routine MR sequence, DWI could provide more useful physiological and functional information for diagnosis.
文摘Objective To assess the reproducibility of whole-body diffusion weighted imaging(WB-DWI) technique in healthy volunteers under normal breathing with background body signal suppression.Methods WB-DWI was performed on 32 healthy volunteers twice within two-week period using short TI inversion-recovery diffusion-weighted echo-planar imaging sequence and built-in body coil.The volunteers were scanned across six stations continuously covering the entire body from the head to the feet under normal breathing.The bone apparent diffusion coefficient(ADC) and exponential ADC(eADC) of regions of interest(ROIs) were measured.We analyzed correlation of the results using paired-t-test to assess the reproducibility of the WB-DWI technique.Results We were successful in collecting and analyzing data of 64 WB-DWI images.There was no significant difference in bone ADC and eADC of 824 ROIs between the paired observers and paired scans(P>0.05).Most of the images from all stations were of diagnostic quality.Conclusion The measurements of bone ADC and eADC have good reproducibility.WB-DWI technique under normal breathing with background body signal suppression is adequate.
