口腔鳞癌淋巴结转移的全身磁共振弥散加权成像的表现

Whole-Body Diffusion Weighted Imaging Manifestation of Oral Squamous Cell Carcinoma with Metastatic Lymph Nodes

目的探讨口腔鳞癌淋巴结转移在全身磁共振弥散加权成像中表现及临床意义。方法21例口腔鳞癌伴淋巴结转移的患者行WB-DWI检查,处理生成全身弥散图。其中19例另行常规MRI增强扫描,9例另用PET检查。全部病例均经病理证实。结果21例患者WB-DWI发现异常淋巴结139个,正常淋巴结11个,炎症淋巴结21个。转移淋巴结呈高信号,ADC值下降,与正常或炎症淋巴结ADC值有统计学差异。结论全身磁共振弥散加权技术在鉴别炎性或正常淋巴结与肿瘤转移性淋巴结方面能够提供准确的信息,是新一代肿瘤病人全身检查的重要方法。

Objective It aims to investigate the manifestation and signification of WB - DWI in examining the oral squamous cell carcinoma with metastatic lymph nodes. Methods 21 cases of oral squamous cell carcinoma with metastatic lymph nodes were examined with WB - DWI, among which 19 were scanned with routine MR, and 9 were examined with PET. All cases were confirmed by pathology. MR scan covered the whole body and built whole body diffusion image after reconstruction with GE HDe 1.5T MR scanner, including STIR - EPI - DWI, b = 0, 800. Results There were 139 metastatic lymph nodes, 11 normal lymph nodes, and 21 inflammatory lymph nodes being found in 21 cases＇ WB - DWI reports. Metastatic lymph nodes showed a higher signal and a lower value of apparent diffusion coefficient （ADC） . The mean ADC value of metastatic lymph nodes was significantly lower than that of inflammato- ry and normal nodes, and normal nodes showed even higher levels of ADC value. Conclusions STIR - EPI - DWI is a new promising technique for differentiating the normal, inflammatory, and metastatic lymph nodes, which provides more useful and functional information for oral malignant tumor.