多参数MRI对舌鳞状细胞癌诊断价值

发布时间：2018-06-03 02:36

本文选题：舌肿瘤 + 鳞状细胞癌　；参考：《中华肿瘤防治杂志》2017年17期

【摘要】：目的 MRI具有无辐射、软组织分辨率高、多参数及多方位成像的优点,也能进行动态增强扫描,可精细评估舌鳞状细胞癌原发灶的部位、大小形态、血供、周围结构受累和淋巴结转移情况等,对于制订临床手术方案有重要意义。本研究探讨弥散加权成像(diffusion weighted imaging,DWI)、MRI平扫及动态增强扫描等多参数MRI在舌鳞状细胞癌中的应用价值及预测颈部淋巴结转移的临床意义。方法回顾性分析经手术病理确诊的37例舌鳞状细胞癌患者的临床和影像学资料,其中有颈部淋巴结转移20例,无颈部淋巴结转移17例。所有病例术前均行头颈部DWI、MRI平扫及动态增强扫描,测量和分析肿瘤的部位、长、短径、厚度、表观扩散系数(apparent diffusion coefficient,ADC)值,比较颈部淋巴结转移组与无转移组间MRI测量参数的差异,同时分析肿瘤时间-信号强度曲线(time intensity curve,TIC)类型。结果 37例舌鳞状细胞癌患者的长径均值为(29±15)mm,短径均值为(24±13)mm,厚度均值为(19±10)mm,ADC均值为(1.067±0.137)×10~(-3) mm~2/s。有、无颈部淋巴结转移患者间,肿瘤长径、短径、厚度和ADC值的差异均有统计学意义,均P值0.05。37例舌鳞状细胞癌患者中21例TIC为速升-平台型,16例TIC为速升-流出型。结论多参数MRI联合应用可较好评价肿瘤的部位、大小、血供、周围结构侵犯及淋巴结转移情况,ADC值与TIC类型对舌鳞状细胞癌的诊断具有重要价值。此外,肿瘤大小对预测淋巴结转移有一定的临床意义。
[Abstract]:Objective MRI has the advantages of non-radiation, high resolution of soft tissue, multi-parameter and multi-directional imaging, and can also perform dynamic contrast-enhanced scanning, which can accurately evaluate the location, size and blood supply of the primary tumor of tongue squamous cell carcinoma. The involvement of peripheral structure and lymph node metastasis are of great significance for clinical operation. The purpose of this study was to investigate the value of diffusion-weighted imaging (DWI) diffusion weighted imaging (DWI) with multiparameter MRI in tongue squamous cell carcinoma (SCC) and its clinical significance in predicting cervical lymph node metastasis. Methods the clinical and imaging data of 37 patients with tongue squamous cell carcinoma confirmed by operation and pathology were retrospectively analyzed. There were 20 cases of cervical lymph node metastasis and 17 cases of no cervical lymph node metastasis. All patients were performed head and neck DWI plain scan and dynamic contrast-enhanced MRI before operation. The location, length, short diameter, thickness and apparent diffusion coefficient (diffusion) of the tumor were measured and analyzed. The difference of MRI measurement parameters between the cervical lymph node metastasis group and the non-metastatic group was compared. At the same time, the time-signal intensity curve and the type of tumor intensity curveted TICs were analyzed. Results the mean of long diameter, short diameter and thickness were 29 卤15mm, 24 卤13mm and 1.067 卤0.137 脳 10 ~ (-3) mm / s respectively in 37 patients with squamous cell carcinoma of tongue. There were significant differences in tumor length, short diameter, thickness and ADC value between patients without cervical lymph node metastasis. P value was 0.05.37 cases of tongue squamous cell carcinoma. 21 cases of TIC were rapid rise-plateau type and 16 cases of TIC were rapid rise-outflow type. Conclusion Multi-parameter MRI can be used to evaluate tumor location, size, blood supply, peripheral structure invasion, lymph node metastasis and TIC type in the diagnosis of tongue squamous cell carcinoma. In addition, tumor size has certain clinical significance in predicting lymph node metastasis.
【作者单位】：山东省济宁市第一人民医院放射科;
【分类号】：R445.2;R739.86

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