不同影像检查对舌癌的诊断价值

The value of different image in diagnosis of tongue cancer

目的:评估CT、MRI、PET-CT、超声术前预测舌癌范围的价值,并探讨影像上舌癌大小与淋巴结转移的关系,为临床治疗提供依据。方法:回顾性分析39例经病理证实的舌癌的影像资料,测量影像上病变直径,与术后病理对比,得到影像与病理直径最相符的检查,并判断病变直径与淋巴结转移之间的关系。结果:CT、MRI、PET-CT、超声均对舌癌部位显示良好,MRI、PET-C对显示舌癌侵犯范围具有一定优越性。与术后对比,MRI和PET-CT病灶范围均大于实体,MRI显示最接近实体,而CT对病灶显示小于实体。超声显示范围较实体小,对于病灶边界显示不如前三者。但能较好的显示肿瘤血供,对提示病变良恶性有一定帮助,MRI显示病灶平均直径≥2cm者,淋巴结转移率85.0%,<2cm者淋巴结转移率仅为15.8%,P<0.005,两者间有统计学差异。结论:MRI、PET-CT对于显示病灶范围优于CT和超声,并可预测淋巴结转移,但PET-CT费用昂贵,因此舌癌术前检查首选MRI。

Objective：To estimate the value of forecasting tongue cancer diameter by CT,MRI,PET-CT and ultrasound,and discuss the relation between size of tongue cancer and rate of lymph migration.Methods： We retrospectively studied the signs and features of tongue cancer in CT,MRI,PET-CT and ultrasound of 39 patients who were verified by pathology,and then measure the diameter of lesion,then contrast to postoperation.Results： The CT,MRI,PET-CT and ultrasound can all display the position of tongue cancer well,and CT,MRI of contrast enhancement all can display range of tongue cancer much better.Contrast to postoperation,MRI and PET-CT display the lager scope than lesion,however CT display less scope than lesion.The ultrasound can provide the evidence of carcinoid or malignancy by bleeding singal.The diameter of lesion ≥2cm,the rate of lymphaden migrate was 85.0%;the diameter of lesion2cm,the rate of lymphaden migrate was 15.8%.Conclusion： MRI,PET-CT are better than CT and ultrasound in displaying the range and can access lymph migrate.