MRI在鉴别咽部恶性肿瘤及黏膜良性增生中的应用价值

The Application Value of MRI in the Differentiation Between Pharynx Malignant Tumor and Pharynx Benign Hyperplasia

目的:探讨MRI在鉴别咽部恶性肿瘤及黏膜良性增生中的价值。方法:回顾性分析经病理证实的214例咽部黏膜良性增生和69例咽部恶性肿瘤患者咽部黏膜增厚的MRI特点,包括咽黏膜增厚的对称性、黏膜线完整性、垂直条纹征、强化程度以及颈部淋巴结增大。应用卡方检验比较2组患者的MRI特点,应用逻辑回归分析预测咽部黏膜良性增生患者的最佳MRI征象。结果:咽部恶性肿瘤患者黏膜增厚不对称、黏膜线不完整、中等强化和颈部淋巴结增大更多见(P<0.05),而咽部黏膜良性增生患者黏膜线完整性、轻度强化和垂直条带征象更多见(P<0.05)。逻辑回归分析表明黏膜线完整、存在垂直条纹征、对称性、弥漫咽黏膜增厚、无颈部淋巴结增大能够预测咽部黏膜良性增生(P<0.001)。结论:MRI对于鉴别咽部恶性肿瘤及黏膜良性增生具有重要价值。

Purpose:To explore the application value of MRI in the differentiation between pharynx malignant tumor(carcinoma and lymphoma)and pharynx benign hyperplasia.Methods:A total of 214 patients with pathologically confirmed pharynx benign hyperplasia and 69 patients with pathologically confirmed pharynx malignant tumor were included.The MRI features of pharynx mucosal thickening including symmetry,deep mucosal white line,vertical striped appearance,enhancement type were recorded,and the cervical lymph nodes enlargement was also recorded.These MRI features were compared byχ2 tests.Logistic regression analysis was done to identify the most predictive MRI features of malignancy.Results:The pattern of pharynx mucosal thickening in malignant tumor was asymmetry,inhomogeneous enhancement,moderated or marked enhancement and with cervical lymph nodes enlargement;while symmetry,deep mucosal white line,slight enhancement and vertical striped appearance were more common in pharynx benign hyperplasia(P<0.05).Logistic regression analysis showed that deep mucosal white line,vertical striped appearance,pharynx wall symmetry,bilateral posterolateral wall thickening,with no cervical lymph nodes enlargement were the most predictive MRI features for pharynx benign hyperplasia.Conclusion:MRI could be used to differentiate the pharynx malignant tumor(carcinoma and lymphoma)from pharynx benign hyperplasia.