Value of apparent diffusion coefficient for differentiating peripancreatic tuberculous lymphadenopathy from metastatic l
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PANCREAS
Value of apparent diffusion coefficient for differentiating peripancreatic tuberculous lymphadenopathy from metastatic lymphadenopathy Jimi Huh1,2 · Jae Ho Byun1 · Jin Hee Kim1 · Seung Soo Lee1 · Hyoung Jung Kim1 · Jae Keun Kim2 · Moon‑Gyu Lee1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To evaluate effectiveness of the apparent diffusion coefficient (ADC) values of the peripancreatic lymphadenopathy to differentiate tuberculous lymphadenopathy from metastatic lymphadenopathy. Materials and methods Twenty-nine patients with 65 peripancreatic necrotic tuberculous lymphadenopathy and 31 patients with 47 peripancreatic necrotic metastatic lymphadenopathy from pancreatic ductal adenocarcinoma, who underwent magnetic resonance imaging (MRI), were included in this study. MRI features in the T1-weighted image (WI), T2WI, and diffusion-weighted image were analyzed. The ADC values of necrotic and non-necrotic portions of the lymph nodes were measured and compared using t test. Receiver operating characteristic analysis was performed to obtain the optimal ADC threshold value and diagnostic accuracy for differentiating tuberculous lymphadenopathy from metastatic lymphadenopathy. Results On T2WI, the signal intensity of necrotic portions was variable in tuberculous lymphadenopathy, but was mostly high in metastatic lymphadenopathy. The mean ADCs of necrotic portions of tuberculous lymphadenopathy were significantly lower than those of metastatic lymphadenopathy ([0.919 ± 0.272] × 10−3 mm2/s vs. [1.553 ± 0.406] × 10−3 mm2/s, p
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