Wiener Edzard, Pautke Christoph, Link Thomas M, Neff Andreas, Kolk Andreas
Department of Diagnostic Radiology, University of Technology Munich, Ismaninger Str. 22, D-81675 Munich, Germany.
Eur J Radiol. 2006 Apr;58(1):113-8. doi: 10.1016/j.ejrad.2005.11.006. Epub 2005 Dec 6.
The goal of this retrospective study was to assess the accuracy of 16-slice multislice CT (MSCT) and MRI in staging of patients with primary squamous cell carcinoma (SCC) of the oral cavity. Fifty-two patients with histologically proven primary SCC were examined with contrast enhanced MSCT and MRI at 1.5 T with a combined head and surface neck coil. Image modalities were evaluated in a blinded fashion by two radiologists and an oral-maxillofacial surgeon in consensus concerning tumour depiction, local tumour infiltration and cervical lymph node metastases. Results of the radiological assessment were correlated with the intraoperative and histopathological findings in all patients. 36 of 52 primary tumours (69.2%) were depicted by MSCT while 44 were localized by MRI (84.6%). Regarding muscle infiltration MRI versus MSCT had a sensitivity of 81.8% versus 72.7%, but a low specificity and an accuracy of 63.4% versus 61% and 67.3% versus 63.5%, respectively, were found. There was a trend towards a better detection of bony infiltration by MRI than MSCT with a sensitivity of 100% versus 71.4%, a specificity of 93.3% versus 95.5% and an accuracy 94.2% versus 92.3%, respectively. Detection of cervical lymph node involvement was similar for MRI and MSCT with a sensitivity of 84.2% and 78.9%, a specificity of 63.6% and 75.7% and an accuracy of 71.1% and 76.9%, respectively. For N-staging both methods failed to detect small metastasis. For T-staging MRI was superior to MSCT, because there was a tendency to underestimate the tumour size by MSCT more often (19.4% versus 6.8% by MRI). Therefore, pre-operative MRI is recommended as the basic imaging modality of choice for treatment planning of oral SCC. MSCT is a valid alternative imaging method especially in cases with low patient compliance.
这项回顾性研究的目的是评估16层多层螺旋CT（MSCT）和MRI对口腔原发性鳞状细胞癌（SCC）患者进行分期的准确性。52例经组织学证实为原发性SCC的患者接受了1.5T的对比增强MSCT和MRI检查，使用联合头部和颈部表面线圈。两名放射科医生和一名口腔颌面外科医生以盲法评估图像模态，就肿瘤描绘、局部肿瘤浸润和颈部淋巴结转移达成共识。对所有患者的放射学评估结果与术中及组织病理学结果进行了相关性分析。52例原发性肿瘤中，MSCT显示36例（69.2%），MRI定位44例（84.6%）。关于肌肉浸润，MRI与MSCT相比，敏感性分别为81.8%和72.7%，但特异性较低，准确性分别为63.4%和61%、67.3%和63.5%。与MSCT相比，MRI检测骨浸润的趋势更好，敏感性分别为100%和71.4%，特异性分别为93.3%和95.5%，准确性分别为94.2%和92.3%。MRI和MSCT检测颈部淋巴结受累情况相似，敏感性分别为84.2%和78.9%，特异性分别为63.6%和75.7%，准确性分别为71.1%和76.9%。对于N分期，两种方法均未能检测到小转移灶。对于T分期，MRI优于MSCT，因为MSCT更常低估肿瘤大小（19.4%，而MRI为6.8%）。因此，建议术前MRI作为口腔SCC治疗计划的基本首选成像方式。MSCT是一种有效的替代成像方法，尤其适用于患者依从性较低的情况。
