磁共振弥散加权成像在口腔鳞癌颈部淋巴结转移中的初步应用

目的：评价磁共振弥散加权成像（MR-DWI）在口腔鳞状细胞癌（OSCC）颈部转移性淋巴结诊断中的应用价值。方法：结合术后病理结果,分别分析51例OSCC患者的CT检查资料及20例OSCC患者的MR-DWI影像资料,采用SPSS16.0软件包中的χ2检验,比较不同检查方法对OSCC颈部转移淋巴结诊断的准确性,确定OSCC患者头颈部MR-DWI扫描的最佳参数设置。结果 ：CT、MR-DWI扫描检查淋巴结转移情况与术后病理结果的符合率分别为69.2%和85.0%。MR-DWI取b值为800s/mm2时图像质量最佳,其诊断的敏感度及特异性分别为87.5%和83.3%,CT为76.2%和63.3%。经χ2检查,MR-DWI扫描诊断结果与术后病理诊断结果具有中等相关性,Kappa值=0.694（P〈0.005）。结论：OSCC颈部转移淋巴结的MR-DWI影像特征与病理诊断结果具有较好的相关性,且与CT检查相比,MR-DWI能够更准确地预测OSCC颈部淋巴结转移情况。

Initial study of diffusion-weighted magnetic resonance imaging for cervical lymph node metastases in patients with oral squamous cell carcinoma

PURPOSE： To evaluate the accuracy and clinical value of diffusion-weighted magnetic resonance imaging（MR-DWI） in diagnosis of cervical lymph node metastases in patients with oral squamous cell carcinoma（OSCC）.METHODS： The CT diagnostic results of 51 OSCC patients were compared with MR-DWI diagnosis of 20 OSCC patients,all the patients’ pathologic diagnosis after cervical lymphadenectomy were clear and well categorized.As main imaging parameter of the MR-DWI was optimized,The diagnostic specificity,sensitivity and accuracy for metastatic nodes of different imaging inspection methods were calculated and compared with Chi-square test according to the pathologic diagnosis which served as the gold standard using SPSS16.0 software package.RESULTS： According to pathologic examination of the dissected specimens,the diagnostic accuracy for metastatic nodes of CT and MR-DWI were 69.2%,85.0%,respectively.When b=800s/mm2,the images of MR-DWI were of high quality and accuracy（sensitivity,87.5%;specificity,83.3%）,compared with CT（sensitivity,76.2%;specificity,63.3%）.Correlation between MR-DWI and pathologic examination was analyzed with Chi-square test（Kappa： 0.694,P〈0.005）.CONCLUSIONS： A good correlation exists between OSCC cervical metastasized lymph node manifestation on MR-DWI and pathologic examination results.MR-DWI is superior to CT examination in ascertaining OSCC cervical lymph node metastasis.