Purpose

To evaluate effectiveness of the apparent diffusion coefficient (ADC) values of the peripancreatic lymphadenopathy to differentiate tuberculous lymphadenopathy from metastatic lymphadenopathy.

Materials and methods

Twenty-nine patients with 65 peripancreatic necrotic tuberculous lymphadenopathy and 31 patients with 47 peripancreatic necrotic metastatic lymphadenopathy from pancreatic ductal adenocarcinoma, who underwent magnetic resonance imaging (MRI), were included in this study. MRI features in the T1-weighted image (WI), T2WI, and diffusion-weighted image were analyzed. The ADC values of necrotic and non-necrotic portions of the lymph nodes were measured and compared using t test. Receiver operating characteristic analysis was performed to obtain the optimal ADC threshold value and diagnostic accuracy for differentiating tuberculous lymphadenopathy from metastatic lymphadenopathy.

Results

On T2WI, the signal intensity of necrotic portions was variable in tuberculous lymphadenopathy, but was mostly high in metastatic lymphadenopathy. The mean ADCs of necrotic portions of tuberculous lymphadenopathy were significantly lower than those of metastatic lymphadenopathy ([0.919 ± 0.272] × 10⁻³ mm²/s vs. [1.553 ± 0.406] × 10⁻³ mm²/s, p < 0.001). Receiver operating characteristic analysis for differentiating tuberculous from metastatic lymphadenopathy demonstrated an area under the curve for the ADC values of necrotic portions of 0.929 (95% CI, 0.865–0.969) with an ADC threshold of 1.022. The sensitivity and specificity for the differentiation of tuberculous from metastatic lymphadenopathy were 80.0% and 97.8%, respectively.

Conclusion

The ADC values of necrotic portions of peripancreatic lymphadenopathy may be useful for differentiating tuberculous from metastatic lymphadenopathy.

中文翻译：

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区分胰周结核性淋巴结病和转移性淋巴结病的表观扩散系数值。

目的

评估胰周淋巴结病的表观扩散系数 (ADC) 值在区分结核性淋巴结病和转移性淋巴结病方面的有效性。

材料和方法

本研究纳入了 29 名接受磁共振成像 (MRI) 的患者，其中 65 名胰周坏死性结核性淋巴结病和 31 名患有胰腺导管腺癌的 47 名胰周坏死性转移性淋巴结病。分析了 T1 加权图像 (WI)、T2WI 和扩散加权图像中的 MRI 特征。测量淋巴结坏死和非坏死部分的ADC值并使用t检验进行比较。进行接受者操作特征分析以获得区分结核性淋巴结病和转移性淋巴结病的最佳ADC阈值和诊断准确性。

结果

在 T2WI 上，坏死部分的信号强度在结核性淋巴结病中是可变的，但在转移性淋巴结病中以高信号强度居多。结核性淋巴结病坏死部分的平均 ADC 显着低于转移性淋巴结病（[0.919 ± 0.272] × 10 ^-3 mm ² /s vs. [1.553 ± 0.406] × 10 ^-3  mm ² /s，p < 0.001)。区分结核性淋巴结病和转移性淋巴结病的接受者操作特征分析表明，坏死部分的 ADC 值的曲线下面积为 0.929（95% CI，0.865–0.969），ADC 阈值为 1.022。区分结核性淋巴结和转移性淋巴结病的敏感性和特异性分别为 80.0% 和 97.8%。

结论

胰周淋巴结病坏死部分的 ADC 值可能有助于区分结核性淋巴结病和转移性淋巴结病。