title: Comparison of CT and MRI for presurgical characterization of paraaortic lymph nodes in patients with pancreatico-biliary carcinoma.
abstract: OBJECTIVE
  To determine the accuracy of computed tomography (CT) and magnetic resonance (MR) for presurgical characterization of paraaortic lymph nodes in patients with pancreatico-biliary carcinoma.
  
  
  METHODS
  Two radiologists independently evaluated CT and MR imaging of 31 patients who had undergone lymphadenectomy (9 metastatic and 22 non-metastatic paraaortic nodes). Receiver operating characteristic (ROC) curve analysis was performed using a five point scale to compare CT with MRI. To re-define the morphologic features of metastatic nodes, we evaluated CT scans from 70 patients with 23 metastatic paraaortic nodes and 47 non-metastatic ones. The short axis diameter, ratio of the short to long axis, shape, and presence of necrosis were compared between metastatic and non-metastatic nodes by independent samples t-test and Fisher's exact test. P < 0.05 was considered statistically significant.
  
  
  RESULTS
  The mean area under the ROC curve for CT (0.732 and 0.646, respectively) was slightly higher than that for MRI (0.725 and 0.598, respectively) without statistical significance (P = 0.940 and 0.716, respectively). The short axis diameter of the metastatic lymph nodes (mean = 9.2 mm) was significantly larger than that of non-metastatic ones (mean = 5.17 mm, P < 0.05). Metastatic nodes had more irregular margins (44.4%) and central necrosis (22.2%) than non-metastatic ones (9% and 0%, respectively), with statistical significance (P < 0.05).
  
  
  CONCLUSIONS
  The accuracy of CT scan for the characterization of paraaortic nodes is not different from that of MRI. A short axis-diameter (> 5.3 mm), irregular margin, and presence of central necrosis are the suggestive morphologic features of metastatic paraaortic nodes.
authors.affiliation: Department of Diagnostic Radiology, Severance Hospital, Seodaemun-ku, Shinchon-dong 134, Seoul 120-752, Korea.
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Kim
authors.forename: Mi-Suk
authors.initials: MS
authors.lastname: Park
authors.forename: Seung-Whan
authors.initials: SW
authors.lastname: Cha
authors.forename: Yong-Eun
authors.initials: YE
authors.lastname: Chung
authors.forename: Joon-Suk
authors.initials: JS
authors.lastname: Lim
authors.forename: Kyung-Sik
authors.initials: KS
authors.lastname: Kim
authors.forename: Myeong-Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Ki-Whang
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000368:Aged; D001011:Aorta / Q000473:pathology*; D001650:Bile Duct Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*