口腔鳞状细胞癌淋巴结转移全身MRI弥散加权成像表现

目的 探讨口腔鳞状细胞癌患者淋巴结转移在全身MRI弥散加权成像中表现及临床意义.方法 对21例口腔鳞状细胞癌伴淋巴结转移的患者行全身MRI弥散加权成像(whole-body diffusion weighted imaging,WB-DWI)检查,处理生成的全身表观弥散系数图.其中19例行常规MRI增强扫描,9例用正电子发射体层摄影术(positron-emission tomography,PET)检查.全部病例淋巴结均经病理证实.结果 21例患者WB-DWI发现异常淋巴结139个,正常淋巴结11个,炎性淋巴结21个.转移淋巴结呈高信号,表观弥散系数(apparent diffusion coefficient,ADC)值(0.78±0.07)下降,与正常(1.78±0.16)或炎性淋巴结(1.18±0.15)ADC值比较,差异有统计学意义(P<0.05).结论 全身MRI弥散加权技术在鉴别正常淋巴结、炎性淋巴结与肿瘤转移性淋巴结方面能够提供准确的信息,是肿瘤患者全身检查的重要方法.

Whole-body diffusion weighted imaging manifestation of oral squamous cell carcinoma with metastatic lymph nodes

Objective To investigate the manifestation of oral squamous cell carcinoma with metastatic lymph nodes in whole-body diffusion weighted imaging (WB-DWI) and its clinical significance.Methods Twenty-one cases of oral squamous cell carcinoma with metastatic lymph nodes were examined by WB-DWI, of which 19 were scanned with routine MRI, 9 cases examined by positron-emission tomography (PET).All cases were confirmed by pathology.MRI scan covered whole body and built whole body diffusion image after reconstruction with GE HDe 1.5T MRI scanner.Results There were 139 metastatic lymph nodes, 11 normal lymph nodes, and 21 inflammatory lymph nodes exhibited by WB-DWI in 21 cases.Metastatic lymph nodes showed higher signal and lower value of apparent diffusion coefficient (ADC).The mean ADC value of metastatic lymph nodes (0.78±0.07) was significantly lower than that of inflammatory (1.18±0.15) and normal nodes (1.78±0.16), and normal nodes showed even higher levels of ADC value, Conclusions STIR-EPI-DWI is a new promising technique for differentiating normal, inflammatory, and metastatic lymph nodes and can provide more useful information on lymph node metastasis.