MR扩散加权成像评价涎腺功能的初步研究  

Application of MR diffusion-weighted imaging in the evaluation of salivary glands with gustatory stimulation

作　　者：张云燕[1] 欧丹[2] 顾雅佳[1] 何霞云[2] 毛健[1] 沈茜刚[1] 岳磊[1] 彭卫军[1] 

机构地区：[1]复旦大学附属肿瘤医院放射诊断科复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学附属肿瘤医院放疗科

出　　处：《中华放射学杂志》2012年第5期425-429,共5页Chinese Journal of Radiology

基　　金：上海市科学技术委员会“科技创新行动计划”资助项目（09Jc1403800）

摘　　要：目的探讨利用MRDWI评价不同生理状态下涎腺功能的可行性。方法对30例涎腺功能正常的鼻咽癌患者行DWIEPI扫描，b值取0、400、600、800、1000s／mm2。先于静息状态下对腮腺及颌下腺各扫描1次，然后给患者含服维生素C100mg×6片，于酸刺激状态下重复对腮腺扫描7次，每次间隔18s。比较静息状态下腮腺和颌下腺ADC值的差别，以及酸刺激前后腮腺ADC值的变化。采用配对t检验对两组间数据进行比较。结果静息状态下，腮腺的ADC值[（1．23±0．12）×10-3mm2／s]显著低于颌下腺[（1．34±0．07）×10-3mm2／s，t=4．545，P〈0．01]。酸刺激后第1次扫描腮腺ADC值为（1．41±0．19）×10-3mm。／s，高于静息时基值（t=10．254，P〈0．01）。随后ADC值在基值上波动，酸刺激后ADC的最小值为（1．24±0．14）×10-3mm2／s，与基值比较差异无统计学意义（t=1．329，P〉0．05）；最大值为（1．49±0．20）×10-3mm2／s，7次扫描的平均值为（1．36±0．17）×10-3mm2／s，均与基值比较差异有统计学意义（t值分别为15．127、11．905，P值均〈0．01）。结论MRDWI通过ADC值的量化，可观察到不同生理状态下涎腺功能的变化。Objective To evaluate the function of the salivary glands with gustatory stimulation by using MR DWI. Methods A prospective study was conducted in 30 patients with nasopharyngeal carcinoma who had normal salivary function. A DWI sequence was performed on the salivary glands at resting state, and continually repeated on the parotid immediately after oral ascorbic acid stimulation over a period of 21 minutes （once every 18 seconds）. The multiple b-values （0,400,600,800, 1000 s/mm2） were used. ADC maps were evaluated with a manually placed region of interest including the entire salivary gland. The ADC of each gland was obtained by taking the mean of values on three contiguous sections containing the largest areas of the gland. The paired two-tailed Student t test was used to compare the ADC values of the parotid and the suhmandibular glands at rest, and of the parotid before and after stimulation. Results The mean ADC value at rest was significantly lower in the parotid [ （1.23 ±0. 12） ×10-3 mm2/s] than in the submandibular glands [ （1.34 ±0. 07） × 10-3 mm2/s, t =4. 545, P 〈0. 01 ]. After acid stimulation, the ADC value increased from the baseline to （1.41 ±0. 19） ×10-3 mm2/s firstly and then fluctuated at the following time, with a peak value of （1.49 ± 0. 20） × 10-3 mm2/s and the average value of （1.36 ± 0. 17） x I0-3 mm2/s. The average value was significantly different from the baseline value （t = 15. 127, t = 11. 905, P 〈0. 01 ）. The minimum value [ （ 1.24 ±0. 14） × 10-3 mm2/s] was not significantly different compared to the baseline value （t = 1. 329, P 〉 0. 05）. Conclusion MR DWI can noninvasively evaluate the physiologic changes of salivary glands before and after acid stimulation.

关 键 词：涎腺 磁共振成像 弥散 

分 类 号：R445.2[医药卫生—影像医学与核医学]