磁共振二维梯度回波序列对头颈部肿块的诊断价值

Diagnostic Value of Head and Neck Neoplasms with 2D Gradient Echo Sequence MR Imaging

目的回顾性评价磁共振(MR)梯度回波(GRE)序列对头颈部肿块的诊断价值。方法对107例头颈部肿块患者的107个头颈肿块病灶行MR-GRE序列成像(T1加权像:270～350ms/12～15ms/75°;T2加权像:400～500ms/20-25ms/15°),并与自旋回波(SE)序列进行对比。所有病灶均经手术和活检病理证实。结果107个头颈肿块病灶中,良性病变58灶,恶性49灶。高和混合高信号病变在GRE-Tl加权像上共有42灶(良性18灶,恶性24灶);在SE-Tl加权像上为3灶(均为良性);GRE-T2加权像上为102灶(良性53灶,恶性49灶);SE-T2加权像上为92灶(良性50灶,恶性42灶)。GRE序列上显示的肿块包膜为4l灶,SE序列上为34灶。结论GRE序列在显示头颈肿块的范围和包膜方面优于SE序列,但其不能鉴别大多数头颈肿块的良恶性质。

Objective The aim of this study is to retrospectively evaluate the diagnostic value of head and neck neoplasms detected with 2D gradient-echo sequence (GRE) MR imaging. Methods One hundred patients with a total of 107 head and neck neoplasms underwent conventional spin-echo and 2D gradient-echo sequences MR imaging (T1-weighted image: 270-350ms/12-15ms/75°; T2-weighted image: 400-500ms/20-25ms/15°). All of 107 head and neck neoplasms (58 benign lesions and 49 malignant lesions) were histopathologically confirmed by biopsy and operation. Results The hyperintense and mixed hyperintense signal neoplasms showed on GRE-T1images in 42 lesions (18 benign and 24 malignant lesions), on SE-T1 images in three lesions (benign), on GRE-T2 images in 102 lesions (53 benign and 49 malignant lesions), and on SE-T2 images in 92 lesions (50 benign and 42 malignant lesions). The capsule of head and neck masses was demonstrated on GRE images in 41 lesions, and on SE images in 34 lesions. Conclusion The authors concluded that 2D gradient-echo MR imaging is superior to spin-echo MR imaging in delineating the extent and capsule of masses, but it is difficult to make differentiating diagnosis between most of benign and malignant head and neck neoplasms.