Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2014, Vol. 36 ›› Issue (1): 73-78.doi: 10.3881/j.issn.1000-503X.2014.01.014

• Original Articles • Previous Articles     Next Articles

Value of Diffusion-weighted Imaging in Diagnosis of Lymph Node Metastasis in Patients with Cervical Cancer

ZHANG Jie, REN Cui, XUE Hua-dan, ZHOU Hai-long, SUN Zhao-yong, JIN Zheng-yu   

  1. Department of Radiology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China
  • Received:2013-07-03 Online:2014-02-28 Published:2014-02-28
  • Contact: JIN Zheng-yu Tel:010-69155441,E-mail:jin_zhengyu@163.com

Abstract: Objective To investigate the value of diffusion-weighted imaging(DWI)in the differentiation of metastatic lymph nodes from non-metastatic lymph nodes in cervical cancer.Methods In 65 patients who underwent lymph node dissection for cervical cancer,conventional MRI and DWI examinations were performed before surgery.Of the 1590 total dissected pelvic lymph nodes,392 enlarged nodes with a short-axis diameter(S)of 5 mm or greater were included for further analysis.Each of the size-based criteria[i.e.,S,long-axis diameter(L),and S/L ratio]and apparent diffusion coefficient(ADC)-based criteria(i.e.,ADCmin,ADCmean,rADCmin,rADCmean)were compared between metastatic lymph nodes and non-metastatic lymph nodes.Results There were statistically significant differences between metastatic and non-metastatic lymph nodes in S,L,S/L ratio,ADCmin,ADCmean,rADCmin ,and rADCmean(all P<0.0001).The Az of the ADCmin(0.956)was greater than that of the other ADC-based criteria and all size-based criteria.Using ADCmin=759.0×10-6 mm2/s,the sensitivity and specificity for differentiating metastatic from non-metastatic lymph nodes were 95.2% and 92.1%,respectively.Conclusion DWI,particularly ADCmin,is feasible for differentiating metastatic from non-metastatic pelvic lymph nodes in patients with cervical cancer.

Key words: cervical cancer, lymph node metastasis, diffusion-weighted imaging

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