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目的探讨在口内酸刺激不同保持时间下主涎腺表观扩散系数(ADC)值的变化规律及差异。方法对18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DW-MRI扫描作为基准。然后,在相邻的两天中的同一时间,向受试者口内滴注5 ml柠檬汁后采用两种不同的刺激方式:一天口内含10 s,另一天口内含2 min后吞咽,然后行扩散加权磁共振成像(DW-MRI)重复扫描各10次。两种刺激方式的先后顺序采取随机原则。分析不同保持时间组酸刺激前后主涎腺ADC值变化曲线的特点及差异,比较两组刺激后最大ADC值、刺激后最大ADC值增加率(IR)以及峰值时间(Tmax)的差别。结果两种不同刺激保持时间组各涎腺平均ADC值均在刺激后第一次扫描时(30 s)达到峰值,之后呈缓慢波动下降的单相变化趋势。柠檬汁含10 s组颌下腺Tmax为(523±415)ms,显著晚于含2 min组的(243±265)ms(t=-3.168,P=0.006)。柠檬汁含10 s组刺激后腮腺、颌下腺与舌下腺的最大ADC值分别为(1.05±0.06)×10-3mm2/s、(1.16±0.07)×10-3mm2/s与(1.11±0.06)×10-3mm2/s,均显著低于含2 min组的(1.09±0.04)×10-3mm2/s、(1.24±0.09)×10-3mm2/s与(1.28±0.18)×10-3mm2/s(腮腺t=-3.393,P=0.003;颌下腺t=-6.655,P=0.000;舌下腺t=-3.665,P=0.002)。两组刺激后各涎腺最大ADC值均显著高于刺激前(P<0.01)。柠檬汁含10 s组刺激后颌下腺最大ADC值IR为(7.94±4.53)%,显著低于含2 min组的(14.26±8.94)%(t=-4.821,P=0.000)。结论柠檬汁味觉刺激后DW-MRI可以显示刺激不同保持时间下各涎腺ADC值变化规律的差异,是评价涎腺分泌功能的合适方法之一。
Objective To investigate the changes and differences of apparent diffusion coefficient (ADC) values of salivary glands under different time of acid stimulation in oral cavity. Methods 18 normal salivary glands in volunteers, resting first in the parotid gland, submandibular gland and sublingual gland DW-MRI scan as a benchmark. Then, at the same time in two adjacent days, two different stimulations were applied to the subject after instillation of 5 ml of lemon juice into the mouth: one day for 10 seconds in the mouth and 2 minutes in the other day for swallowing, Then, diffusion-weighted MR imaging (DW-MRI) scanning was performed 10 times each. The order of the two stimuli takes the stochastic principle. The characteristics and differences of the ADC value of the main salivary glands before and after acid stimulation at different holding time were analyzed. The maximum ADC value, the maximum ADC value (IR) and the peak time (Tmax) after stimulation were compared between the two groups. Results The average ADC values of salivary glands in the two different stimulation holding time groups all reached the peak values at the first scan after stimulus (30 s), and then showed a single phase change trend with slow fluctuation. The Tmax of submandibular gland in 10 s lemon juice group was (523 ± 415) ms, significantly lower than that of 2 min group (243 ± 265) ms (t = -3.168, P = 0.006). The maximal ADC values of parotid gland, submandibular gland and sublingual gland were (1.05 ± 0.06) × 10-3mm2 / s, (1.16 ± 0.07) × 10-3mm2 / s and (1.11 ± 0.06) (1.09 ± 0.04) × 10-3mm2 / s, (1.24 ± 0.09) × 10-3mm2 / s and (1.28 ± 0.18) × 10-3mm2 / s) s (parotid gland t = -3.393, P = 0.003; submandibular gland t = -6.655, P = 0.000; sublingual gland t = -3.665, P = 0.002). The maximum ADC values of salivary glands in both groups were significantly higher than those before stimulation (P <0.01). The maximum ADC value of submandibular gland stimulated by 10 s lemon juice was (7.94 ± 4.53)%, which was significantly lower than that of 2 min (14.26 ± 8.94)% (t = -4.821, P = 0.000). Conclusion DW-MRI after taste stimulated by lemon juice can show the variation of ADC value of salivary glands at different holding time, which is one of the suitable methods to evaluate salivary gland secretion.