两种不同味觉刺激物刺激后MR扩散加权成像评价涎腺功能的对比研究  

Comparative study on quantitative evaluation of normal salivary glands function by diffusion-weighted MR imaging after gustatory stimulation using two different stimuli

作　　者：徐亮[1] 赵丹蕾 田野[2] 沈钧康[1] 范秋虹[2] 范国华[1] 龚建平[1] 钱铭辉[1] 

机构地区：[1]苏州大学附属第二医院影像科,215004 [2]苏州大学附属第二医院放疗科,215004

出　　处：《中华放射学杂志》2016年第2期81-85,共5页Chinese Journal of Radiology

基　　金：江苏省临床医学科技专项（BL2014040）;苏州市科技发展计划项目（SYSD2011096）

摘　　要：目的探讨应用不同刺激物味觉刺激后行主涎腺MRDWI成像时ADC值变化规律的差异。方法本研究为前瞻性，收集30名涎腺功能正常的志愿者，先于静息状态下行1次腮腺、颌下腺和舌下腺的MRDWI扫描作为基准；然后应用自身对照法，对每名志愿者分别采用柠檬汁和维生素C片味觉刺激后，行MRDWI动态扫描13次。测定静息及刺激后唾液流率。对比2种刺激物刺激前后各涎腺ADC值变化曲线的特点及差异，采用两独立样本t检验比较2种刺激物刺激后各涎腺最大ADC值、最大ADC增加率（IR）以及达峰时间（Tmax）的差异。采用Pearson相关性检验分析各涎腺静息ADC值与静息唾液流率、刺激后最大ADC值与刺激后唾液流率以及刺激后最大ADC值IR与唾液流率IR之间的相关性。结果受柠檬汁刺激后各涎腺的平均ADC值多于味觉刺激后的第一次扫描达到峰值[腮腺（1．05±0．12）×10^-3mm^2/s，颌下腺（1．22±0．10）×10^-3mm^2/s，舌下腺（1．26±0．21）×10^-3mm^2/s]，此后ADC值呈逐步下降趋势。受维生素C片刺激后各涎腺平均ADC值于味觉刺激后第一次扫描明显升高，此后ADC值呈逐步缓慢上升趋势直至峰值[达峰时间，腮腺（418±296）s，颌下腺（454±301）s，舌下腺（528±297）s）]；最大ADC值，腮腺（1．13±0．13）×10^-3mm^2／s，颌下腺（1．32±0．25）×10^-3mm^2／s，舌下腺（1．57±0．36）×10^-3mm^2/s。受柠檬汁刺激后颌下腺与舌下腺Tmax[颌下腺：（184±122）s，舌下腺：（345±232）s）]显著小于受维生素C片刺激后（t值分别为-3．517、-2．548，P值均〈0．01）；各涎腺受刺激后最大ADC值均低于维生素C片组，其中腮腺与舌下腺间差异有统计学意义（t值分别为-2．894、-3．681，P值均〈0．01）；各涎腺刺激后最大ADC值IR[腮腺（11．35±4．07）％，颌下腺（8．81±5．40）％，舌下腺（34．08±21．66）％]均显著低于维Objective To investigate the difference of apparent diffusion coefficients （ADCs） changes in three major salivary glands after gustatory stimulation using two different stimuli. Methods Thirty healthy volunteers were examined with a 1.5 T MR unit. A diffusion-weighted MR imaging （MR DWI） sequence was performed once at rest and continuously repeated 13 times after gustatory stimulation using a commercially available lemon juice and vitamin C tablets in the same volunteer by using self-controlled method. The subsequence of two stimuli was random. In addition, the salivary flow rates at rest and after stimulation were measured. Characteristics and differences in ADCs curves of three salivary glands before and after stimulation between two stimuli were analyzed. Comparison of maximum ADCs, maximum ADCs increase rates （IRs） and times to maximum ADCs（Tmax） between two stimuli was performed by using independent-samples t test. Correlation analysis between rest salivary flow rates and rest ADCs, the maximum salivary flow rates and ADCs after stimulation, the maximum salivary flow IRs and ADC IRs after stimulation were performed by using Pearson correlation test. Results In lemon juice stimulation group, the mean ADCs mostly showed a steady increase to peak values during the first DW MRI scan after stimulation in all glands, followed by a gradually decrease fluctuating slightly around the baseline values. In vitamin C stimulation group, the mean ADCs were significantly increased in all glands during the first DW MRI scan after stimulation, followed by a gradual upward trend till peak values. In lemon juice stimulation group, the mean Tmax of submandibular and sublingual glands[（184±122）s, （345±232）s, respectively] were significantly earlier than those[（454 ± 301）s, （528 ± 297）s, respectively] in vitamin C stimulation group （t=-3.517 and- 2.548 respectively, P〈0.01 for all）. The mean maximum ADCs of three glands in lemon juice stimulation group[（1.05±0.12） x 10.3 mm2/s, （1.2

关 键 词：涎腺 磁共振成像 味觉 刺激 化学性 扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R781.7[医药卫生—诊断学]