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目的:探讨MR弥散加权成像对舌根及舌咽部实质性肿瘤的鉴别诊断价值。方法:对61例舌根及舌咽部实质性肿瘤患者行术前常规MRI及MR-DWI检查。根据术后病理结果,将病变分为4组。第1组,良性实质性肿瘤(n=10);第2组,上皮癌(n=35);第3组,非上皮性恶性肿瘤(n=16);第4组,恶性肿瘤(n=51,为第2、3组的合并)。在b值取0,1000 s/mm~2的情况下,计算各类肿瘤的ADC均值。回顾性分析和比较不同病理类型肿瘤之间的ADC均值差异。使用SAS9.1软件包进行Wilcoxon检验,比较各组病变的ACD值差异。结果:第1组和其他3组之间的平均ADC值存在显著差异(P<0.05),第2组和第3组之间的平均ADC值亦存在显著差异(P<0.05)。在所有病理类型中,非霍奇金淋巴瘤的平均ADC值最低,而神经鞘瘤的平均ADC值最高。另外,不同类型的上皮癌之间ADC值无显著差异(P>0.05)。结论:MR-DWI能鉴别不同类型的舌根及舌咽部实质性肿瘤,对于良、恶性病变,上皮癌和非上皮性恶性肿瘤的鉴别具有较高价值。
Objective: To investigate the differential diagnosis value of MR diffusion weighted imaging in the tongue base and glossopharyngeal solid tumors. Methods: Totally 61 cases of tongue base and glossopharyngeal parenchyma were examined by routine MRI and MR-DWI. According to the postoperative pathological results, the lesions were divided into 4 groups. Group 1 benign tumor (n = 10); group 2, epithelial carcinoma (n = 35); group 3, non-epithelial malignancies 51 for the merging of Groups 2 and 3). In the b value of 0,1000 s / mm ~ 2 cases, calculate the average of each type of tumor ADC. The ADC mean differences between different pathological types of tumors were retrospectively analyzed and compared. Wilcoxon test was performed using the SAS 9.1 software package to compare differences in ACD values between the groups. Results: There was a significant difference (P <0.05) in mean ADC values between group 1 and 3, and between groups 2 and 3 (P <0.05). In all pathological types, the average ADC value of non-Hodgkin’s lymphoma is the lowest, while the average ADC value of schwannoma is the highest. In addition, there was no significant difference in ADC values between different types of epithelial carcinomas (P> 0.05). Conclusion: MR-DWI can identify different types of tongue base and glossopharyngeal parenchymal tumors, and has high value for the differential diagnosis of benign and malignant lesions, epithelial cancers and non-epithelial malignancies.