MR成像在判断涎腺病变性质中的价值  

Malignant or benign salivary gland lesions: predicting with MR imaging

作　　者：王继琛[1] 李优伟[2] 蒋学祥[1] 王霄英[1] 肖江喜[1] 

机构地区：[1]北京大学第一医院放射科,北京100034 [2]北京航天中心医院放射科,北京100039

出　　处：《中国医学影像技术》2005年第9期1422-1424,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的确定MR成像是否可用于判断涎腺病变的性质,以及其诊断的准确性。方法对60例经手术病理证实的病例进行回顾性分析。将10个MR表现参数进行逻辑回归分析,确定哪些参数可预测涎腺病变的良、恶性。结果逻辑回归分析表明:在包括炎症病例的情况下,仅转移(P<0.001)征象可预测病变的性质。而在不包括炎症病例条件下,颈部淋巴结肿大和周围结构侵蚀在预测涎腺恶性病变方面具有显著意义。用转移征象预测恶性病变的准确性为83.0%、敏感性为43.8%、特异性为100%;而侵蚀征象预测恶性病变的准确性84.9%、敏感性为50%、特异性为100%。当应用转移征象和/或侵蚀征象来预测恶性病变时,准确性为92.5%、敏感性为75%、特异性为100%。结论颈部淋巴结肿大和周围结构侵蚀在确定恶性涎腺病变方面具有较高的价值。Objective To evaluate if MR imaging can be used to diagnosis the nature of the salivary gland lesions, and the accuracy of this modality. Methods Sixty patients with salivary gland diseases that included 7 cases of inflammatory lesions were analyzed respectively. All cases were diagnosed pathologically. A logistic regression model was used to determine which MR imaging features were significant factor for predicting the lesion being benign or malignant for each patient. Resuits Logistic regression model analysis in 60 cases revealed that metastasis was only significant MR characteristics for determining a lesion that was benign or malignant （P〈0. 001）. Its accuracy, sensitivity and specificity for predicting malignancy were 97.7%, 43.8%, 83.3%, respectively. However, the analysis in 53 cases （excluding inflammatory cases） demonstrated that metastases （P〈0. 001） and infiltration （P〈0. 001） were significant factors in predicting a malignant lesion, respectively. Their accuracy, sensitivity and specificity for predicting malignancy were 100%, 43.8%, 83.0% and 100%, 50 %, 84.9 %, respectively. When combining these two predictors to diagnosis malignancy, their accuracy, sensitivity and specificity could improve to 92.5%, 75%, and 100%. Conclusion Lymph node swelling and infiltration of tumor are useful factors to differentiate the malignant or benign lesions.

关 键 词：涎腺疾病 肿瘤 磁共振成像 

分 类 号：R781.7[医药卫生—口腔医学] R445.2[医药卫生—临床医学]