Objective To study the MRI findings of primary anterior mediastinal Hodgkin lymphoma(PAMHL)and its value in Ann Arbor clinical staging.Methods A total of 32 patients with PAMHL confirmed by histopathology were en-rolled retrospectively.The MRI findings were evaluated independently by two radiologists in double-blinded manner,inclu-ding tumor size,homogeneity,fibrous septum sign,apparent diffusion coefficient(ADC)value,and so on.Subsequently,we analyzed the inter-observer agreement of these MRI findings and assessed their values in the differential diagnosis of early-stage and advanced-stage PAMHL.Results The size of PAMHL ranged from 5.3 cm to 20.5 cm,with an average length of(9.6±3.7)cm.Twenty-five lesions(78.1％)presented heterogeneous signal intensity;20 lesions(62.5％)showed fibrous septum sign,18 of which were nodular sclerosis HL;16 lesions(50.0％)appeared as lymph node fusion;29 le-sions(90.6％)had lymphadenectasis,15 of which showed mass-like lymph nodes with short diameter≥3 cm.Among the 32 PAM HL,tumors invaded lung tissue in 15 cases(46.9％),pericardium in 13 cases(40.6％),blood vessel in 10 cases(31.3％),chest wall in 7 cases(21.9％),and phrenic nerve in 1 case(3.1％).The average ADC value of PAMHL was(0.801±0.112)×10-3mm2/s.Mass-like lymph node was significantly more seen in advanced-stage than in early-stage PAMHL(P=0.014).Conclusion PAMHL has certain characteristic MRI findings.Mass-like lymph node can be used to distinguish early-stage and advanced-stage PAMHL,which is helpful to guide clinical staging and predict prognosis.
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