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Comparison of CT and MRI for presurgical characterization of paraaortic lymph nodes in patients with pancreatico-biliary carcinoma

查看全文 作　　者：Young Chul [1]Kim;Mi-Suk [1]Park;Seung-Whan [2]Cha;Yong Eun [1]Chung;Joon Suk [1]Lim;Myeong-Jin [1]Kim;Ki Whang [1]Kim;Kyung Sik [3]Kim 高影响力作者 机构地区：[1]Department of Diagnostic Radiology and Institute of Gastroenterology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 120-752, Korea;[2]Department of Diagnostic radiology and Institute of Gastroenterology, Yonsei University Wonju College of Medicine, Wonju 220-701, Korea;[3]Department of General surgery and Institute ofGastroenterology, Severance Hospital, Yonsei University Collegeof Medicine, Seoul 120-752, Korea高影响力机构 出　　处：《World Journal of Gastroenterology》索引2008年第14卷第14期,共5页高影响力期刊 摘　　要：AIM:To determine the accuracy of computed tomography (CT) and magnetic resonance (MR) for presurgical characterization of paraaortic lymph nodes in patients with pancreatico-biliary carcinoma. METHODS:Two radiologists independently evaluated CT and MR imaging of 31 patients who had undergone lymphadenectomy (9 metastatic and 22 non-metastatic paraaortic nodes). Receiver operating characteristic (ROC) curve analysis was performed using a five point scale to compare CT with MRI. To re-define the morphologic features of metastatic nodes, we evaluated CT scans from 70 patients with 23 metastatic paraaortic nodes and 47 non-metastatic ones. The short axis diameter, ratio of the short to long axis, shape, and presence of necrosis were compared between metastatic and non-metastatic nodes by independent samples t-test and Fisher's exact test. P < 0.05 was considered statistically significant. RESULTS:The mean area under the ROC curve for CT (0.732 and 0.646, respectively) was slightly higher than that for MRI (0.725 and 0.598, respectively) without statistical significance (P = 0.940 and 0.716,respectively). The short axis diameter of the metastatic lymph nodes (mean = 9.2 mm) was significantly larger than that of non-metastatic ones (mean = 5.17 mm, P < 0.05). Metastatic nodes had more irregular margins (44.4%) and central necrosis (22.2%) than non-metastatic ones (9% and 0%, respectively), with statistical significance (P < 0.05). CONCLUSION:The accuracy of CT scan for the characterization of paraaortic nodes is not different from that of MRI. A short axis-diameter (> 5.3 mm), irregular margin, and presence of central necrosis are the suggestive morphologic features of metastatic paraaortic nodes. 关 键 词：CT检查 MRI检查 手术治疗 胆管癌
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