24例口腔癌颈部转移淋巴结的MRI诊断

Magnetic resonance imaging diagnosis of 24 cases of cervical lymph node metastasis from oral carcinoma

目的通过对24例口腔癌患者颈部淋巴结的临床触诊、MRI检查、术后病理确诊的对比性研究,探讨MRI在口腔癌颈淋巴转移诊断中的作用。方法收集本院24例口腔癌患者,行口腔癌颌颈联合根治术后经病理证实淋巴转移12例,非转移(炎性淋巴结)12例,对其临床触诊和MRI扫描与颈淋巴清扫术标本病理检查结果分别进行对比分析研究。结果MRI和临床触诊诊断颈部淋巴转移准确性分别为91·7%和75%;诊断炎性淋巴结的准确性分别为83·3%和75%;同时口腔癌转移淋巴结的MRI表现,T1加权为均匀略低和等信号,T2加权表现为均匀的略高信号与高信号混合。转移淋巴结轮廓清晰,周围可出现不完全环状脂肪增生带,而炎性淋巴结在T1和T2加权上分别为等信号和略高信号,且周边欠清晰,边缘脂肪模糊。结论MRI相对有较高的诊断准确性,可作为口腔癌术前常规颈淋巴转移普查的一种有效方法。

Objective This study was to assess the efficiency of MRI diagnosis in neck lymph node metastatic oral carci- noma by the contrast research between clinical touch and MRI diagnosis according postoperative pathology. Methods Twenty- four cases of oral carcinoma were collected in Union Hospital affiliated to FMU, 12 of which were pathological neck lymph node metastasis, and the others were nonmetastatic. The accuracy of diagnosis by preoperative clinical touch and MRI diagnosis was studied. Results In metastatic neck lymph nodes, the diagnostic accuracy of clinical touch and MRI scan was 75% and 91.7% respectively, while in inflammatory nodes the same value was 75% and 83.3% respectively, meanwhile the MRI scanning in o- ral carcinoma of neck lymph node metastasis shows iso-hypo or iso intensity on T1 WI, and iso-hyper on T2 WI, and the margins of this nodes were smooth and well-delineared, with incomplete loop-like zone of fat atropy, while in inflammatory nodes, it showed iso intensity on T1WI, and iso-hyper on T2WI, the margins of this nodes was unclear, and the fat zone around them was blurred. Conclusion MRI can be served as a routine preoperative examination in oral carcinoma diagnosis for its relative ac- curacy.