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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。
Objective: To study the influence of the liquefaction part of the node on the measurement of apparent diffusion coefficient (ADC value) in oral squamous cell carcinoma (OSCC) metastatic lymph nodes in DW-MRI. Methods: According to the results of postoperative pathological examination, the DW-MRI data of 25 patients with OSCC were analyzed. The ADC value of the metastatic lymph nodes including the parenchyma of the metastatic lymph nodes and the metastatic lymph nodes including the liquefied part were selected and measured respectively. Two independent samples t-test to compare the difference between two groups of ADC values. Results: In all cases, there were 11 cases of cervical lymph node metastasis. A total of 15 metastatic lymph nodes were detected. Significant local liquefaction occurred in 8 of the metastatic lymph nodes. The whole lymph node including lymph node metastasis (SMLN group) and the entire lymph node (LMLN group) were (872.1 ± 22.65) × 10-6 mm2 / s (n = 15) and (1073 ± 16.99) × 10-6mm2 / s (n = 8) respectively. Two independent samples t-test showed that there was a significant difference (P <0.05) between SMLN group and LMLN group ADC value. CONCLUSION: The average ADC value in the selected area can be increased by the liquefied area in the metastatic lymph node of OSCC. If the ADC value is significant, the liquefied area in the selected area may reduce the diagnostic accuracy of DW-MRI in detecting metastatic lymph nodes of OSCC.