Application of DWI and ADC values in differential diagnosis of cervical lymph nodes in patients with nasopharyngeal carcinoma

doi:10.11958/20250046

Abstract

Abstract:

Objective To explore the value of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) in magnetic resonance imaging (MRI) in differential diagnosis of benign and malignant cervical lymph nodes in patients with nasopharyngeal carcinoma. Methods Clinical data of 98 patients diagnosed with nasopharyngeal carcinoma were retrospectively analyzed. This cohort included 65 patients with pathologically confirmed malignant lymph nodes and 33 patients with benign lymph nodes. Prior to pathological diagnosis, all patients underwent routine MRI scans and DWI. ADC values of both benign and malignant lymph nodes were recorded. The diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis. Additionally, the diagnostic efficacy of MRI and ADC values in distinguishing benign and malignant lymph nodes of nasopharyngeal carcinoma was compared. Results Of the 65 patients with malignant lymph nodes, 42 cases were accompanied by liquefactive necrosis, and 13 cases were accompanied by extracapsular invasion. Most benign lymph nodes showed no signal on DWI sequence, while malignant lymph nodes showed obvious high signal or mixed signals. The ADC value of benign lymph nodes was (1.724±0.365)×10^-3 mm²/s, which was higher than that of malignant nodes (1.022±0.210)×10^-3 mm²/s (P<0.01). The ROC curve analysis results showed that the area under the curve of ADC value for diagnosing benign and malignant lymph nodes was 0.843(95%CI: 0.782-0.904), with a cutoff value of 1.363×10^-3 mm²/s. At this point, the sensitivity and specificity for differentiating benign and malignant lymph nodes were 0.856 and 0.849, respectively, and Youden index was 0.705. When the ADC value was lower than the cutoff value, the accuracy, sensitivity and specificity for differentiating cervical lymph nodes in nasopharyngeal carcinoma patients were 0.878, 0.892 and 0.848, respectively, which were superior to MRI (P<0.05). Conclusion The DWI images of malignant lymph nodes in patients with nasopharyngeal carcinoma show high signal and low ADC, and ADC has high efficiency in the differential diagnosis of benign and malignant cervical lymph nodes.

Key words: nasopharyngeal carcinoma, lymph nodes, magnetic resonance imaging, diffusion weighted imaging, apparent diffusion coefficient

CLC Number:

R739.63

Figures/Tables 4

Fig.1 MRI and pathological findings of malignant lymph nodes

Fig.2 MRI and pathological findings of benign lymph nodes

Fig.3 ROC curve of ADC for differential diagnosis of benign and malignant cervical lymph nodes in nasopharyngeal carcinoma

Tab.1 Qualitative diagnosis and histopathological diagnosis of different examination methods

方法	病理组织学诊断结果		合计
方法	恶性	良性	合计
MRI平扫
恶性	48	13	61
良性	17	20	37
ADC
恶性	58	5	63
良性	7	28	35
合计	65	33	98

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