Differentiation between normal and metastatic lymph nodes in patients with skin melanoma: Preliminary findings using a DIXON-based whole-body MRI approach

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open Pub Date : 2024-03-19 DOI:10.1016/j.ejro.2024.100560

C. Brussaard , L. Faggioni , F.E. Ramirez-Barbosa , M. Vervoort , Y. Jansen , B. Neyns , J. de Mey , I. Willekens , D. Cioni , E. Neri

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引用次数: 0

Abstract

Purpose

Metastatic melanoma lymph nodes (MMLns) might be challenging to detect on MR-WBI, as both MMLns and normal lymph nodes (NLns) can show restricted water diffusion. Our purpose is to assess the potential contribution of the DIXON sequence in differentiating MMLns from NLns.

Material and methods

We followed a cohort of 107 patients with stage IIIb/c and IV skin melanoma for 32 months using MR-WBI with DIXON, STIR, and DWI/ADC sequences. We compared signal intensity (SI) values of MMLns and NLns in the four series of the DIXON sequence (in/out-of-phase, fat_only, and water_only series). The fat fraction (SI_{fat_only}/SI_in) and the long:short axis ratio of MMLns were calculated. The fat fraction was also calculated in the fatty hila of NLns.

Results

All MMLns (8 from 7 patients) showed SI_out>SI_in with a mean fat fraction of 10%. In 40 normal fatty hila (25 patients), the proportion of SI_out>SI_in was 100% and mean fat fraction was 89% (p<0.001 for fat fraction, Mann-Whitney U-test). In the cortex of NLns, a SI_out>SI_in pattern was identified in 41/113 cases from 19/40 patients. The median long:short axis ratio in MMLns was 1.13 (range 1.03–1.25).

Conclusion

The combination of three features of MMLns (SI_out>SI_in, low-fat fraction and rounded shape) might hold promise in differentiating NLns from MMLns in patients with skin melanoma. Further research is warranted due to the small number of MMLns in our cohort.

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区分皮肤黑色素瘤患者的正常淋巴结和转移淋巴结：基于 DIXON 全身磁共振成像方法的初步研究结果

目的由于转移性黑色素瘤淋巴结（MMLns）和正常淋巴结（NLns）都会表现出水扩散受限，因此在MR-WBI上检测转移性黑色素瘤淋巴结（MMLns）可能具有挑战性。我们的目的是评估 DIXON 序列在区分黑色素瘤淋巴结和正常淋巴结方面的潜在贡献。材料和方法我们对一组 107 例 IIIb/c 期和 IV 期皮肤黑色素瘤患者进行了长达 32 个月的 MR-WBI 随访，使用了 DIXON、STIR 和 DWI/ADC 序列。我们比较了 DIXON 序列四个序列（相内/相外、纯脂肪和纯水序列）中 MMLns 和 NLns 的信号强度（SI）值。计算了MMLns的脂肪分数（SIfat_only/SIin）和长短轴比。结果所有 MMLns（7 位患者中的 8 位）都显示出 SIout>SIin，平均脂肪率为 10%。在 40 个正常脂肪组织（25 名患者）中，SIout>SIin 的比例为 100%，平均脂肪率为 89%（脂肪率 p<0.001，Mann-Whitney U 检验）。在 19/40 例患者的 41/113 例 NLns 皮层中，发现了 SIout>SIin 模式。结论结合 MMLns 的三个特征（SIout>SIin、低脂肪率和圆形）可能有助于区分皮肤黑色素瘤患者中的 NLns 和 MMLns。由于我们队列中的 MMLns 数量较少，因此还需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology Open Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.10

自引率

5.00%

发文量

审稿时长

51 days