Features of Computed Tomography Perfusion of Mediastinal Lymphadenopathies: a Pathology-based Retrospective Study

doi:10.1016/S1001-9294(15)30041-9

摘要/Abstract

摘要： Objective To explore the features of various mediastinal lymphadenopathies using computed tomography perfusion (CTP).Methods CTP parameters (CTPs) of the selected mediastinal nodes from 59 patients with pathology-proven malignant lymph nodes and of those from 29 patients with clinically diagnosed or pathology-proven inflammatory lymphadenopathies were collected. Patients were divided into subgroups by etiology and phase of primary disease, including different pathological malignant nodes and diverse inflammatory nodes. CTPs were defined as blood flow (BF), blood volume (BV), mean transit time (MTT), permeability (PMB), and time to peak (TTP). Differences of CTPs were compared between malignant and benign nodes, and among subgroups, respectively.Results In the mediastinum, no significant differences of CTPs were found between malignant and benign groups (all P>0.05), the same for subgroups of malignant nodes (all P>0.05). Acute lymphadenitis had higher BF and BV than chronic inflammatory, lymphoid tuberculosis, sarcoidosis and malignant nodes. The BF of malignant nodes was markedly slower than that of acute lymphadenitis (P=0.01), but faster than chronic inflammatory nodes (P=0.04) and sarcoidosis (P=0.03), with no significant difference compared with lymphoid tuberculosis. Pneumonia-complicated lymphoid tuberculosis showed the longest MTT while sarcoidosis displayed the shortest MTT, and inflammatory nodes, lymphoid tuberculosis without complicated pneumonia and malignant nodes had moderate MTT.Conclusion CTPs show promising potential in distinguishing various lymphadenopathies in the mediastinum, but more studies are needed to improve their specificity.

关键词: mediastinal lymphadenopathy, computed tomography perfusion, functional computed tomography

Abstract: Objective To explore the features of various mediastinal lymphadenopathies using computed tomography perfusion (CTP).Methods CTP parameters (CTPs) of the selected mediastinal nodes from 59 patients with pathology-proven malignant lymph nodes and of those from 29 patients with clinically diagnosed or pathology-proven inflammatory lymphadenopathies were collected. Patients were divided into subgroups by etiology and phase of primary disease, including different pathological malignant nodes and diverse inflammatory nodes. CTPs were defined as blood flow (BF), blood volume (BV), mean transit time (MTT), permeability (PMB), and time to peak (TTP). Differences of CTPs were compared between malignant and benign nodes, and among subgroups, respectively.Results In the mediastinum, no significant differences of CTPs were found between malignant and benign groups (all P>0.05), the same for subgroups of malignant nodes (all P>0.05). Acute lymphadenitis had higher BF and BV than chronic inflammatory, lymphoid tuberculosis, sarcoidosis and malignant nodes. The BF of malignant nodes was markedly slower than that of acute lymphadenitis (P=0.01), but faster than chronic inflammatory nodes (P=0.04) and sarcoidosis (P=0.03), with no significant difference compared with lymphoid tuberculosis. Pneumonia-complicated lymphoid tuberculosis showed the longest MTT while sarcoidosis displayed the shortest MTT, and inflammatory nodes, lymphoid tuberculosis without complicated pneumonia and malignant nodes had moderate MTT.Conclusion CTPs show promising potential in distinguishing various lymphadenopathies in the mediastinum, but more studies are needed to improve their specificity.

Key words: mediastinal lymphadenopathy, computed tomography perfusion, functional computed tomography

Lin Ou-yang, Guang-ming Lu. Features of Computed Tomography Perfusion of Mediastinal Lymphadenopathies: a Pathology-based Retrospective Study[J].Chinese Medical Sciences Journal, 2015, 30(3): 162-169.

参考文献 19

1.	1.Song T, Shen YG, Jiao NN, et al. Esophageal squamous cell carcinoma: assessing tumor angiogenesis using multi-slice CT perfusion imaging. Dig Dis Sci 2012; 57: 2195-202.
2.	Razek AA, Tawfik AM, Elsorogy LG, et al. Perfusion CT of head and neck cancer. Eur J Radiol 2014; 83: 537-44.
3.	3.Preda L, Calloni SF, Moscatelli ME, et al. Role of CT perfusion in monitoring and prediction of response to therapy of head and neck squamous cell carcinoma. Biomed Res Int 2014; 2014: 917150.
4.	Kazmierczak PM, Nikolaou K, Rominger A, et al. Radiological diagnostics in CUP syndrome. Radiology 2014; 54: 117-23.
5.	Bisdas S, Baghi M, Smolarz A, et al. Quantitative measurements of perfusion and permeability of orophar- yngeal and oral cavity cancer, recurrent disease, and associated lymph nodes using first-pass contrastenhan- ced computed tomography studies. Invest Radiol 2007; 42: 172-9.
6.	Liu Y, Bellomi M, Gatti G, et al. Accuracy of computed tomography perfusion in assessing metastatic involve- ment of enlarged axillary lymph nodes in patients with breast cancer. Breast Cancer Research 2007; 9: R40.
7.	Trojanowska A, Trojanowski P, Bisdas S, et al. Squamous cell cancer of hypopharynx and larynx-evaluation of metastatic nodal disease based on computed tomography perfusion studies. Eur J Radiol 2012; 8: 1034-9.
	8.Sahani DV, Kalva SP, Hamberg LM, et al. Assessing tumor perfusion and treatment response in rectal cancer with multisection CT: initial observations. Radiology 2005; 234: 785-92.
	9.Feng ST, Sun CH, Li ZP, et al. Evaluation of angiogenesis in colorectal carcinoma with multidetector-row CT multislice perfusion imaging. Eur J Radiol 2010; 75: 191-6.
10	Hoshida T, Isaka N, Hagendoorn J, et al. Imaging steps of lymphatic metastasis reveals that vascular endothelial growth factor-C increases metastasis by increasing delivery of cancer cells to lymph nodes: therapeutic implications. Cancer Res 2006; 66: 8065-75.
	11.Ouyang L, Zhou ST, Chen MH, et al. CT perfusion time-density curve morphosis of lymphadenopathy and its clinical significance. Chin J Med Imaging Technol 2012; 28: 144-8.
	12.Ahmed HG, Nassar AS, Ginawi I. Screening for tuberculosis and its histological pattern in patients with enlarged lymph node. Patholog Res Int 2011; 2011: 417635.
13	Kuo CH, Chen HC, Chung FT, et al. Diagnostic value of EBUS-TBNA for lung cancer with non-enlarged lymph nodes: a study in a tuberculosis-endemic country. PLoS One 2011; 6: e16877.
14	Pollard RE, Garcia TC, Stieger SM, et al. Quantitative evaluation of perfusion and permeability of peripheral tumors using contrast-enhanced computed tomography. Invest Radiol 2004; 39: 340-9.
15	Koh DM, Brown G, Temple L, et al. Rectal cancer: mesorectal lymph nodes at MR imaging with USPIO versus histopathologic findings initial observations. Radiology 2004; 231: 91-9.
	16.d'Assignies G, Couvelard A, Bahrami S, et al. Pancreatic endocrine tumors: tumor blood flow assessed with perfusion CT reflects angiogenesis and correlates with prognostic factors. Radiology 2009; 250: 407-16.
	17.Wu GY, Ghimire P. Perfusion computed tomography in colorectal cancer:Protocols, clinical applications and em- erging trends. World J Gastroenterol 2009; 15: 3228-31.
18	Spira D, Adam P, Linder C, et al. Perfusion and flow extraction product as potential discriminators in untreated follicular and diffuse large B cell lymphomas using volume perfusion CT with attempt at histopathologic explanation. AJR Am J Roentgenol 2012; 198: 1239-46.
19	Zhang H, Pan ZL, Du LJ, et al. Advanced gastric cancer and perfusion imaging using a multidetector row com- puted tomography: correlation with prognostic deter- minants. Radiology 2008; 9: 119-27.

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