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目的:评价磁共振弥散加权成像(MR-DWI)在口腔鳞状细胞癌(OSCC)颈部转移性淋巴结诊断中的应用价值。方法:结合术后病理结果,分别分析51例OSCC患者的CT检查资料及20例OSCC患者的MR-DWI影像资料,采用SPSS16.0软件包中的χ2检验,比较不同检查方法对OSCC颈部转移淋巴结诊断的准确性,确定OSCC患者头颈部MR-DWI扫描的最佳参数设置。结果 :CT、MR-DWI扫描检查淋巴结转移情况与术后病理结果的符合率分别为69.2%和85.0%。MR-DWI取b值为800s/mm2时图像质量最佳,其诊断的敏感度及特异性分别为87.5%和83.3%,CT为76.2%和63.3%。经χ2检查,MR-DWI扫描诊断结果与术后病理诊断结果具有中等相关性,Kappa值=0.694(P<0.005)。结论:OSCC颈部转移淋巴结的MR-DWI影像特征与病理诊断结果具有较好的相关性,且与CT检查相比,MR-DWI能够更准确地预测OSCC颈部淋巴结转移情况。
Objective: To evaluate the value of MR-DWI in the diagnosis of cervical metastatic lymph nodes in oral squamous cell carcinoma (OSCC). Methods: According to the postoperative pathological results, CT examination data of 51 OSCC patients and MR-DWI imaging data of 20 OSCC patients were analyzed respectively. Chi-square test was used in the SPSS16.0 software package to compare the different methods of examining the cervical metastasis of OSCC The accuracy of the diagnosis of lymph nodes, to determine the optimal head and neck MR imaging MR-DWI scan parameter settings. Results: The coincidence rates of CT and MR-DWI in detecting lymph node metastasis and postoperative pathological findings were 69.2% and 85.0% respectively. The best image quality was obtained with b-value of 800s / mm2 for MR-DWI. The diagnostic sensitivity and specificity were 87.5% and 83.3% for MR-DWI and 76.2% and 63.3% for CT respectively. By χ2 examination, MR-DWI scan diagnostic results and postoperative pathological diagnosis of moderate correlation, Kappa value = 0.694 (P <0.005). CONCLUSIONS: MR-DWI imaging features of OSCC cervical lymph node metastasis have a good correlation with the pathological diagnosis results. MR-DWI can predict the cervical lymph node metastasis of OSCC more accurately than CT.