MR弥散加权成像对舌根及舌咽部实质性肿瘤的诊断价值

doi:10.19439/j.sjos.2017.04.019

上海口腔医学 ›› 2017, Vol. 26 ›› Issue (4): 441-446.doi: 10.19439/j.sjos.2017.04.019

MR弥散加权成像对舌根及舌咽部实质性肿瘤的诊断价值

朱文静, 余强, 王平仲^*, 石慧敏^*

上海交通大学医学院附属第九人民医院放射科,上海 200011

收稿日期:2017-02-23 修回日期:2017-04-18 出版日期:2017-08-25 发布日期:2017-09-01
通讯作者: 王平仲,E-mail：kcb027@163.com;石慧敏,E-mail: 2240542827@qq.com。*共同通信作者
作者简介:朱文静（1983-）,女,硕士,主治医师,E-mail：amanda_1983_328@yahoo.com.cn

Diagnostic value of diffusion-weighted magnetic resonance imaging for solid tumors affecting the base of tongue and glossopharynx

ZHU Wen-jing, YU Qiang, WANG Ping-zhong, SHI Hui-min

Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2017-02-23 Revised:2017-04-18 Online:2017-08-25 Published:2017-09-01

摘要/Abstract

摘要： 目的探讨MR弥散加权成像对舌根及舌咽部实质性肿瘤的鉴别诊断价值。方法对61例舌根及舌咽部实质性肿瘤患者行术前常规MRI及MR-DWI检查。根据术后病理结果,将病变分为4组。第1组,良性实质性肿瘤（n=10）;第2组,上皮癌（n=35）;第3组,非上皮性恶性肿瘤（n=16）;第4组,恶性肿瘤（n=51,为第2、3组的合并）。在b值取0,1000 s/mm2的情况下,计算各类肿瘤的ADC均值。回顾性分析和比较不同病理类型肿瘤之间的ADC均值差异。使用SAS9.1软件包进行Wilcoxon检验,比较各组病变的ACD值差异。结果第1组和其他3组之间的平均ADC值存在显著差异（P<0.05）,第2组和第3组之间的平均ADC值亦存在显著差异（P<0.05）。在所有病理类型中,非霍奇金淋巴瘤的平均ADC值最低,而神经鞘瘤的平均ADC值最高。另外,不同类型的上皮癌之间ADC值无显著差异（P>0.05）。结论MR-DWI能鉴别不同类型的舌根及舌咽部实质性肿瘤,对于良、恶性病变,上皮癌和非上皮性恶性肿瘤的鉴别具有较高价值。

关键词: 磁共振, 弥散加权成像, 舌根, 舌咽部

Abstract: The objective of the present study was to evaluate the potential application value of diffusion-weighted magnetic resonance imaging (DW-MRI) to differentiate solid benign from malignant tumors affecting the base of tongue and glossopharynx. METHODS: Sixty-one patients who presented with solid tumors affecting the base of tongue and glossopharynx underwent conventional MRI and DW-MRI before pathologic verification. Based on pathologic findings, the tumors were classified into 4 groups: Group 1, solid benign tumor (n=10); Group 2, epithelial carcinoma (n=35); Group 3: non- epithelial malignant tumor (n=16); and Group 4: malignant tumor (n=51, a combination of Group 2 and 3). The mean apparent diffusion coefficients (ADCs) were computed from DW-MRI scans obtained with b factors of 0 and 1000 s/mm2. SAS 9.1 software package was used for Wilcoxon test. RESULTS: The mean ADCs were significantly different (P<0.05) between group 1 and the other 3 groups, and between group 2 and group 3, respectively. Among all kinds of pathological types of lesions, non-Hodgkin lymphoma had a lowest mean ADC value, and schwannoma had a highest mean ADC value. In addition, the mean ADCs among epithelial carcinoma subtypes were not significantly different(P>0.05). CONCLUSIONS: DW-MRI has differential diagnostic value of solid tumors affecting the base of tongue and glossopharynx, especially in distinguishing between benign solid tumors and malignant tumors, and between epithelial carcinomas and non-epithelial malignant tumors.

Key words: Magnetic resonance imaging, Diffusion-weighted imaging, Base of tongue, Glossopharynx

中图分类号:

R739.8

朱文静, 余强, 王平仲, 石慧敏. MR弥散加权成像对舌根及舌咽部实质性肿瘤的诊断价值[J]. 上海口腔医学, 2017, 26(4): 441-446.

ZHU Wen-jing, YU Qiang, WANG Ping-zhong, SHI Hui-min. Diagnostic value of diffusion-weighted magnetic resonance imaging for solid tumors affecting the base of tongue and glossopharynx[J]. Shanghai Journal of Stomatology, 2017, 26(4): 441-446.

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MR弥散加权成像对舌根及舌咽部实质性肿瘤的诊断价值

Diagnostic value of diffusion-weighted magnetic resonance imaging for solid tumors affecting the base of tongue and glossopharynx

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