Application value of three-dimensional pseudocontinuous arterial spin labeling in diagnosing cervical small lymph node metastases in nasopharyngeal carcinoma
Objective:To investigate the value of three-dimensional pseudocontinuous arterial spin labeling(3D pCASL)in diagnosing cervical small metastatic lymph node(SMLN)in nasopharyngeal carcinoma.Materials and Methods:A total of 63 cases of nasopharyngeal carcinoma were collected retrospectively.A combination of routine plain scanning,enhanced magnetic resonance imaging(MRI),and 3D pCASL scanning was conducted prior to treatment.Subsequent follow-ups involved routine plain scanning and enhanced MRI post-treatment.The evaluation of lymph nodes was based on the criteria for assessing lymph node metastasis established by the nasopharyngeal carcinoma Clinical Staging Committee of our country,combined with MRI images during the follow-up period.According to the diagnostic outcomes,the lymph nodes were categorized into three groups:large metastatic lymph node(LMLN)group(short diameter>10 mm),SMLN group(short diameter≤10 mm),and benign lymph node(BLN)group.The differences among various groups in terms of the maximum diameter,minimum diameter,ratio of minimum diameter to maximum diameter,average blood flow(BFavg),minimum blood flow(BFmin),and maximum blood flow(BFmax)of lymph nodes were compared among all groups.The diagnostic efficacy of various parameters for cervical SMLN in nasopharyngeal carcinoma was evaluated using the receiver operating characteristic(ROC)curve.Results:A total of 323 cervical lymph nodes were included,with 152 in the SMLN group,97 in the LMLN group,and 74 in the BLN group.There were statistically significant differences in maximum diameter,minimum diameter,the ratio of minimum diameter to maximum diameter,BFavg,BFmax,and BFmin among the SMLN,LMLN,and BLN groups(P<0.001).The maximum diameter,minimum diameter,and the ratio of minimum diameter to maximum diameter in the LMLN group were all greater than those in the SMLN and BLN groups(P<0.001).The shortest diameter and the ratio of shortest diameter to maximum diameter in the SMLN group were both greater than those in the BLN group(P=0.010,P<0.001).The BFavg,BFmax,and BFmin in the BLN group were all lower than those in the SMLN and LMLN groups(P<0.001).There were no statistically significant differences in maximum diameter between the BLN and SMLN groups,as well as in BFavg,BFmax,and BFmin between the LMLN and SMLN groups(P>0.05).ROC analysis revealed that the area under the curve(AUC)values for differentiating BLN from SMLN in nasopharyngeal carcinoma using minimum diameter,the ratio of minimum diameter to maximum diameter,BFavg,BFmax,and BFmin were 0.712,0.740,0.952,0.990,and 0.791,respectively.The corresponding cut-off values were 0.55 cm,0.59,39.4 mL/(min·100 g),58.5 mL/(min·100 g),and 25.5 mL/(min·100 g),respectively.Conclusions:3D pCASL can effectively differentiate cervical SMLN in nasopharyngeal carcinoma,enhancing the accuracy of N staging for nasopharyngeal carcinoma.
万方数据
维普
