CT、磁共振对头面部皮肤鳞状细胞癌肿瘤侵犯范围的诊断价值探讨

The diagnostic value of CT and MRI in the invasion of squamous cell carcinoma of the head and face

目的分析电子计算机断层扫描(CT)、磁共振(MRI)对头面部皮肤鳞状细胞癌肿瘤侵犯范围的诊断价值。方法选择头面部皮肤鳞状细胞癌患者64例为观察对象,均行CT或MRI检查,收集并分析CT、MRI影像资料,采用内部一致性系数评价CT、MRI与病理学检查判断肿瘤侵犯范围的一致性。结果22例行CT检查的患者中,16例(84.21%)诊断为皮下脂肪层中断,病理学检查确诊19例皮下脂肪层中断,Kappa值为0.69,一致性一般(P<0.05)。42例行MRI检查的患者中,诊断为皮下脂肪层中断、颅骨受累、硬膜受累分别有34例(97.14%)、24例(92.31%)、15例(75.00%),病理学检查确诊皮下脂肪层中断、颅骨受累、硬膜受累的患者分别为35例、26例、20例,Kappa值为0.79,一致性较好(P<0.05)。结论头面部皮肤鳞状细胞癌在MRI、CT影像学表现具有一定特点,可结合临床表现进行术前诊断,且MRI在评估肿瘤侵犯范围方面更具优势,可作为治疗前评估病情进展的影像学手段。

Objective To analyze the diagnostic value of computed tomography(CT)and magnetic resonance imaging(MRI)in the scope of tumor invasion in the head and face squamous cell carcinoma(SCC).Methods Totally 64 pa-tients with squamous cell carcinoma of the head and face were selected as the study subjects.All underwent CT or MRI examinations,and the collected CT and MRI imaging data were analyzed.The internal consistency coefficient was used to evaluate the consistency between CT,MRI,and pathological examination in determining the extent of tumor invasion.Results Among 22 patients underwent routine CT scans,16 cases(84.21%)were subcutaneous fat layer disruption,and pathological examination revealed 19 cases of subcutaneous fat layer disruption.Kappa value for CT and pathological examination in diagnosing the extent of tumor invasion was 0.69,with moderate consistency(P<0.05).In 42 patients who underwent MRI scans,34 cases(97.14%),24 cases(92.31%),and 15 cases(75.00%)were subcutaneous fat layer disruption,involvement of the skull bone,and involvement of the dura mater,respectively.The pathological examination showed subcutaneous fat layer disruption,involvement of the skull bone,and involvement of the dura mater were 35,26,and 20 cases,respectively.Kappa value for MRI and pathological examination in diagnosing the extent of tumor invasion was 0.79,with good consistency(P<0.05).Conclusion Head and face squamous cell carcinoma has certain character-istics in MRI and CT imaging,which can be combined with clinical manifestations for preoperative diagnosis.MRI has better advantages in evaluating the scope of tumor invasion,and can be used as an imaging measure to evaluate the prog-ress of the disease before treatment.