结内液化区域对口腔鳞状细胞癌转移淋巴结表观弥散系数测量的影响  

Study of the influence of nodal liquefaction in measurement of the ADC value of OSCC metastatic lymph nodes in patients with oral squamous cell carcinoma

作　　者：司家文[1,2] 胡启凡[2] 黄圣运[2] 邹虎威[2] 史俊[1] 张东升[2] 沈国芳[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔颅颌面科,上海市口腔医学重点实验室,上海200011 [2]山东大学附属省立医院口腔颌面外科,山东济南250021

出　　处：《上海口腔医学》2015年第1期98-101,共4页Shanghai Journal of Stomatology

基　　金：上海市科学技术委员会资助项目(SHDC12013103)~~

摘　　要：目的:研究结内液化部分对口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)转移淋巴结在DW-MRI影像中表观弥散系数(ADC值)测量的影响。方法:结合术后病理检查结果,分析25例OSCC患者的DW-MRI影像资料,分别选取和测量转移淋巴结实质部分和包括液化部分在内的整个转移淋巴结的ADC值,采用SPSS 17.0软件包中的两独立样本t检验比较2组ADC值间的差异。结果:所有病例中存在颈淋巴结转移者11例,共检出15个转移淋巴结,其中8个转移淋巴结内发生明显局部液化,测量转移淋巴结实质部分(SMLN组)和包括液化部分在内的整个淋巴结(LMLN组)的平均ADC值分别为(872.1±22.65)×10-6 mm2/s(n=15)、(1073±16.99)×10-6mm2/s(n=8)。两独立样本t检验显示,SMLN组与LMLN组ADC值间具有显著差异(P<0.05)。结论:OSCC转移淋巴结内的液化区域可以造成选区内平均ADC值升高,如果在测量ADC值时选区内包含明显液化区域,则可能降低DW-MRI对OSCC颈部转移淋巴结诊断的准确性。PURPOSE： To study the influence of nodal liquefaction portion in the measurement of the ADC value of metastatic lymph nodes in patients with oral squamous cell carcinoma（OSCC） on DW-MRI images. METHODS：According to the postoperative histopathological examination results, the DW-MRI data of 25 OSCC patients was analyzed.The ADC values of both solid portions of metastatic lymph nodes and the whole metastatic lymph nodes with internal liquefaction were selected and measured. Further comparison between the 2 groups was processed for 2 independent samples t test with SPSS 17.0 software package. RESULTS： Eleven patients out of all cases were diagnosed with cervical lymph node metastasis, and 15 metastatic lymph nodes were detected, among which 8 metastatic lymph nodes had obvious internal liquefaction. The average ADC values of solid portions of metastatic lymph nodes（group SMLN） and the whole metastatic lymph nodes with internal liquefaction（LMLN group） ADC were（872.1 ±22.65） ×10-6mm2/s（n =15） and（1073 ±16.99） ×10-6mm2/s（n =8）, respectively. Two independent samples t test showed statistically significant difference of ADC values between group SMLN and group LMLN（P0.05）. CONCLUSIONS： The internal liquefaction in OSCC metastatic lymph nodes can lead to an increased average ADC value. If the measurement of OSCC metastatic lymph nodes includes obvious liquefaction portions, it may reduce the diagnostic accuracy of DW-MRI for discrimination of lymph node metastasis.

关 键 词：口腔癌 鳞状细胞癌 颈淋巴结转移 扩散加权成像 表观弥散系数 

分 类 号：R739.8[医药卫生—肿瘤]