磁共振成像在儿童腺样体肥大诊断中的应用价值

Value of Magnetic Resonance Imaging in Diagnosis of Pediatric Adenoid Hypertrophy

目的通过分析儿童腺样体肥大磁共振成像(MRI)表现,探讨磁共振成像(MRI)在儿童腺样体肥大诊断中的应用价值。方法对46例疑似腺样体肥大患儿治疗前均行MRI常规T1WI、T2WI I横轴位和矢状位扫描,以MR-SE T1WI正中矢状面为测量面,分别记录腺样体肥大的厚度(A)、腺样体/鼻咽腔比值(A/N)及鼻咽通气孔(PAS)大小。将46例患者按治疗或术后病理结果分为2组:研究组31例为腺样体肥大患儿,对照组15例为非腺样体肥大患儿;比较2组的MRI特征。结果 46例MRI均表现为鼻咽顶后壁软组织增厚,鼻咽腔变窄,在T1WI呈均匀、中等信号,在T2WI呈中等稍高信号。研究组A/N为0.746 7±0.050 0,对照组为0.593 5±0.068 0,2组相比差异有统计学意义(P<0.01);研究组PAS为(4.983±1.270)mm,对照组为(7.894±1.630)mm,2组相比差异有统计学意义(P<0.01);ROC曲线分析:以A/N>0.67、PAS<6.5 mm可作为诊断腺样体肥大的临界值。结论 MRI可在腺样体肥大诊断中作出准确的量化,为临床提供了全面、直观的影像学信息,有利于临床制定出更为有效的治疗方案。

Objective To explore the diagnostic value of magnetic resonance imaging （MRI） in pediatric adenoidal hypertrophy through analyzing the MRI manifestation. Methods The axial TIWI and sagittal T2WI I MRI was performed in 46 children with suspected adenoid hypertrophy. The thickness of adenoidal hypertrophy （A）, adenoid/nasopharyngeal cavity （A/N） ratio and nasopharyngeal vent size（PAS） were measured in the MR-SE T1WI median sagittal plane. These children were divided into two groups according to the postoperative pathologic results： adenoidal hypertrophy group （study group, n=31） and non-adenoidal hypertrophy group（control group, n=15）. MRI features were compared between the two groups. Results MRI showed posterior nasopharyngeal wall thickening of soft tissue and nasopharyngeal narrowing. Adenoidal hypertrophy showed homogeneous and moderate intensity on T1WI and slightly high signal intensity on T2WI. The A/N ratio and PAS were, respectively, 0.746 7±0.050 0 and （4.983＋1.270） mm in study group, and 0.593 5±0.068 0 and （7.894±1.630） mm in control group. There were significant differences between the two groups （P〈0.01）. ROC curve analysis showed A/N〉0.67 and PAS〈6.5 mm could be used as the critical values in the diagnosis of adenoidal hypertrophy. Couclusion MRI can make an accurate quantification in the diagnosis of adenoidal hypertrophy, provide comprehensive and intuitionistic imaging information, and contribute to developing more effective treatments.