舌和口底鳞状细胞癌和脉管畸形的DCE-MRI评价

Dynamic Contrast Enhanced MR Imaging in the Evaluation of Squamous Cell Carcinoma and Vascular Malformation of Tongue and Floor of Mouth

目的:评价舌和口底鳞状细胞癌(SCC)和脉管畸形的MRI动态增强扫描(DCE-MRI)的特点。方法:对治疗前行常规MRI和DCE-MRI检查的39例舌和口底SCC及9例脉管畸形(均经手术病理证实)患者的病例资料进行回顾性分析。根据病变的时间-信号强度曲线(TIC)和最大斜率值,采用统计方法比较其在舌和口底SCC与脉管畸形之间的差异。结果:48例中TIC曲线可分3型:Ⅰ型35例(SCC34例,脉管畸形1例),Ⅱ型12例(SCC5例,脉管畸形7例),Ⅲ型1例(为脉管畸形),单因素方差分析显示舌和口底SCC与脉管畸形的TIC类型之间差异有极显著性意义(χ2=15.74,P<0.001)。舌和口底SCC及脉管畸形的TIC最大斜率平均值分别为42.08和37.02,差异有显著性意义(P<0.05);以最大斜率值38.6为阈值,其鉴别舌和口底SCC与脉管畸形的敏感度、特异度和符合率分别为87.1%、66.7%和81.6%。结论:结合TIC曲线类型和最大斜率对舌和口底部SCC与脉管畸形的诊断和鉴别诊断具有参考价值。

Objective：To evaluate the characteristics of MR dynamic contrast-enhanced imaging （DCE-MRI） of squamous cell carcinoma （SCC） and vascular malformation （VM） in tongue and floor of mouth. Methods：Forty-eight patients had SCC （39 patients） and VM （9 patients） in tongue and floor of mouth,both conventional MR imaging and DCE-MRI were performed prior to surgery and proved by pathology,all the clinical materials were retrospectively analyzed.The time intensity curve （TIC） and its maximum slope value of the lesions were analyzed statistically.Results：The TIC of these 48 patients could be classified into 3 types,including type Ⅰ （35 patients,34 patients with SCC and 1 with VM）,type Ⅱ （12 patients,5 patients with SCC and 7 with VM）,and type Ⅲ （1 patient with VM）.Significant statistical differences of TIC types were existed between SCC and VM （χ^2=15.74,P〈0.001）.The mean maximum slope value of SCC and VM was 42.08 and 37.02 respectively,with significant statistical difference （P〈0.05）.Used 38.6 as threshold of maximum slope value for the differential diagnosis of SCC and VM,the sensitivity,specificity and accuracy was 87.1%,66.7 and 81.6% respectively.Conclusion：TIC in combination with maximal slope value provided valuable information in the differential diagnosis of SCC and VM in tongue and floor of mouth.