(1) Background: This study aims to evaluate the image quality of abnormal cervical lymph nodes in head and neck cancer and the diagnostic performance of detecting extranodal extension (ENE) using free-breathing StarVIBE. (2) Methods: In this retrospective analysis, 80 consecutive head and neck cancer patients underwent StarVIBE before neck dissection at an academic center. Image quality was compared with conventional VIBE available for 28 of these patients. A total of 73 suspicious metastatic lymph nodes from 40 patients were found based on morphology and enhancement pattern on StarVIBE. Sensitivity (SN), specificity (SP), and odds ratios were calculated for each MR feature from StarVIBE to predict pathologic ENE. (3) Results: StarVIBE showed significantly superior image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) for enlarged lymph nodes compared to VIBE. The MR findings of “invading adjacent planes” (SN, 0.54; SP, 1.00) and “matted nodes” (SN, 0.72; SP, 0.89) emerged as notable observations. The highest diagnostic performance was attained by combining these two features (SN, 0.93; SP, 0.89). (4) Conclusions: This study confirms that StarVIBE offers superior image quality for abnormal lymph nodes compared to VIBE, and it can accurately diagnose ENE by utilizing a composite MR criterion in head and neck cancer.
（1）背景：本研究旨在评估自由呼吸StarVIBE序列对头颈癌异常颈部淋巴结的成像质量及其诊断淋巴结外侵犯（ENE）的效能。（2）方法：本回顾性分析纳入某学术中心连续80例头颈癌患者，在颈部清扫术前均接受StarVIBE序列扫描，其中28例患者同时具备传统VIBE序列数据用于图像质量对比。基于StarVIBE序列的形态学与强化特征，共从40例患者中识别出73枚可疑转移淋巴结。通过计算各MRI特征的敏感性（SN）、特异性（SP）及比值比，评估StarVIBE序列对病理证实的ENE的预测能力。（3）结果：相较于VIBE序列，StarVIBE在肿大淋巴结的成像质量、信噪比（SNR）及对比噪声比（CNR）方面均显著更优。MRI特征中"侵犯邻近平面"（SN 0.54，SP 1.00）与"融合淋巴结"（SN 0.72，SP 0.89）表现突出，联合此两项特征可获得最佳诊断效能（SN 0.93，SP 0.89）。（4）结论：本研究证实StarVIBE序列对异常淋巴结的成像质量优于VIBE序列，通过复合MRI标准可准确诊断头颈癌的淋巴结外侵犯。
肿瘤(癌症)患者之家