[Malignant lymphoma: magnetic resonance tomography findings in residual supradiaphragmatic space-occupying lesions].
OBJECTIVE
Evaluation of MR imaging in patients with Hodgkin's lymphoma and high grade non-Hodgkin's-lymphoma and mediastinal residual mass after first line chemotherapy.


METHODS
MR imaging (1.5 T) was performed in 36 patients (Hodgkin's lymphoma n = 26, NHL n = 10) after first line chemotherapy). Twenty patients had inactive residual mass, 16 patients had residual lymphoproliferative lesions. T1- and T2-weighted spin echo images were visually analysed by a score index (range 1-5) as well as quantification of enhancement by signal-intensity-ratios SImax/SIplain).


RESULTS
For the differentiation between residual lymphoproliferative activity and inactive residual mass, the highest accuracy was obtained for the signal intensity of residual mass on T2-w-SE compared to pectoralis muscle (94% sensitivity, 80% specificity, likelihood ratios: 4.0 [LR+]; 0.3 [LR-]). The cut-off value of the SI ratio was calculated retrospectively at 1.96 (p > 0.05).


CONCLUSIONS
Differentiation between inactive (fibrotic) and lymphoproliferative (active) residual mediastinal mass is possible by MR imaging using as parameter the size reduction after therapy and the signal intensity on T2-w-SE in comparison to pectoralis muscle. Thus study suggests an additional value using the SI ratio for the differentiation.
Stroszczynski
C
C
Klinik für Strahlenheilkunde, Charité Campus Virchow Klinikum, Medizinische Fakultät der Humboldt-Universität zu Berlin. stros@charite.de
Hosten
N
N
Oellinger
J
J
Spahn
G
G
Amthauer
H
H
Bittner
R C
RC
Hierholzer
J
J
Ludwig
W D
WD
Felix
R
R
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008482:Mediastinum / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D012680:Sensitivity and Specificity; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone