Jia Mu-yun, Duan Qing-yun, Yuan Rong-tao, Shang Wei, Zhao Jie, Wang Guo-ming
Department of Oral and Maxillofacial Sugery, The Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2008 Aug;43(8):488-91.
To investigate the value of single photon emission computed tomography(SPECT)-computed tomography(CT) in diagnosis of oral carcinoma invasion to mandible.
Thirty-four patients with oral carcinoma invasion to mandible were divided into two groups, group A (surrounding invasion) and group B (central invasion). The edge of the invasion was evaluated by SPECT-CT, CT and pathological examination. The results of CT and SPECT-CT were analyzed by quantitative methods.
In group A, the cancer-invaded area of the mandible exhibited on SPECT-CT was 1.0 cm lager than that on pathological examination, 2.4 cm lager than that on CT. The difference of invaded area shown on CT was 1.4 cm smaller than that of pathological examination. There were significant difference among the three methods. In group B, the affected area on SPECT-CT was 1.2 cm lager than that of pathological examination, 4.2 cm lager than that of CT. The invision area on CT was 3.0 cm smaller than that of pathological examination. There were significant difference among the three methods.
SPECT-CT could find the jaw central tumor earlier than CT and the range of lesion showed by SPECT-CT was the adequate range of bone incision during operation. The range of lesion showed by CT was influenced by the type of tumor and the range of bone incision was determined according to the pathological type. If the false negative result was eliminated, only SPECT-CT or CT was needed to estimate the invasion range of mandible.
探讨单光子发射计算机断层扫描(SPECT)-计算机断层扫描(CT)在诊断口腔癌侵犯下颌骨中的价值。
将34例口腔癌侵犯下颌骨患者分为两组,A组(周围侵犯)和B组(中央侵犯)。通过SPECT-CT、CT和病理检查评估侵犯边缘。采用定量方法分析CT和SPECT-CT的结果。
A组中,SPECT-CT显示的下颌骨癌侵犯区域比病理检查大1.0 cm,比CT大2.4 cm。CT显示的侵犯区域差异比病理检查小1.4 cm。三种方法之间存在显著差异。B组中,SPECT-CT上的受累区域比病理检查大1.2 cm,比CT大4.2 cm。CT上的侵犯区域比病理检查小3.0 cm。三种方法之间存在显著差异。
SPECT-CT比CT能更早发现颌骨中央肿瘤,且SPECT-CT显示的病变范围是手术中合适的骨切除范围。CT显示的病变范围受肿瘤类型影响,骨切除范围需根据病理类型确定。若消除假阴性结果,仅需SPECT-CT或CT来评估下颌骨的侵犯范围。