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首页> 外文期刊>Radiologia Brasileira >Contribution of dynamic contrast enhancement and diffusion-weighted magnetic resonance imaging to the diagnosis of malignant cervical lymph nodes
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Contribution of dynamic contrast enhancement and diffusion-weighted magnetic resonance imaging to the diagnosis of malignant cervical lymph nodes

机译：动态对比增强和弥散加权磁共振成像对恶性宫颈淋巴结诊断的贡献

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The importance of imaging diagnosis in identifying and characterizing cervical lymph nodes is undeniable, especially in tumor staging, in which it influences decisions related to the initiation, adjustment, or discontinuation of treatment(1). The limitations of conventional magnetic resonance imaging (MRI) for the differentiation between benign and malignant involve ment are also recognized, because a reactive lymph node can be enlarged in the same way as a metastatic lymph node, and a normal-sized lymph node can be malignant(2). Functional MRI techniques are increasingly used to aid in that differentiation.Diffusion-weighted MRI sequences can identify change in cytoarchitecture and cell density, allowing the use of apparent diffusion coefficient (ADC) values for the characterization of small (4–9 mm) metastatic lymph nodes(3), for which the mor phology and size criteria would yield false-negative results(4). In addition, many studies have demonstrated the importance of post-treatment assessment with diffusion-weighted imaging, suggesting that, by as soon as two weeks after the initiation of treatment, ADC values can indicate whether or not the pre scribed pharmacological treatment has been successful(5). The various techniques of dynamic study after injection of contrast medium allow characterization of vascular permeability and identification of neovascularization, suggestive of metastatic lymph nodes(6). Spectroscopy demonstrates a change in the concentration of metabolites, which can guide the diagnosis(3).
机译：影像学诊断在识别和表征宫颈淋巴结中的重要性是不可否认的，尤其是在肿瘤分期中，它会影响与治疗的开始，调整或终止有关的决定（1）。还认识到常规磁共振成像（MRI）在良恶性病变之间的区别，因为反应性淋巴结可以与转移性淋巴结一样扩大，正常大小的淋巴结可以扩大。恶性的（2）。功能性MRI技术已越来越多地用于辅助这种分化。弥散加权MRI序列可以识别细胞结构和细胞密度的变化，从而允许使用表观扩散系数（ADC）值来表征小的（4–9 mm）转移淋巴节点（3），其形态和大小标准会产生假阴性结果（4）。此外，许多研究已经证明了采用扩散加权成像进行治疗后评估的重要性，这表明，在开始治疗后两周内，ADC值可以表明处方药治疗是否成功（5）。注射造影剂后进行的各种动态研究技术可表征血管通透性并鉴定新血管形成，提示转移性淋巴结转移（6）。光谱显示代谢物浓度的变化，可以指导诊断（3）。

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