Wang Pingzhong, Yang Jie, Yu Qiang, Ai Songtao, Zhu Wenjing
Department of Radiology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jun;109(6):900-7. doi: 10.1016/j.tripleo.2010.01.005.
The aim of this study was to evaluate the value of diffusion-weighted magnetic resonance (MR) imaging in differentiating various masticator-space solid lesions.
Before surgery and/or pathologic verification, diffusion-weighted echo-planar MR imaging was performed on 78 subjects who had lesions in their masticator spaces. Based on their pathologic outcomes, lesions were classified into 3 groups: group 1: benign tumors and tumor-like lesions (23 cases); group 2: inflammatory diseases (14 cases); and group 3: malignant tumors (41 cases). Mean apparent diffusion coefficients (ADCs) were calculated from diffusion-weighted MR images that were obtained with a b factor of 0 and 1,000 s/mm(2). Differences between groups and lesion types were statistically compared with the Kruskal-Wallis and Mann-Whitney U tests.
The ADCs were significantly different (P = .0001) among the 3 groups, between group 1 (1.52 +/- 0.29 [SD] x 10(-3) mm(2)/s) and group 2 (1.01 +/- 0.31 x 10(-3) mm(2)/s), and between group 1 and group 3 (1.11 +/- 0.29 x 10(-3) mm(2)/s). There was no statistically significant difference (P = .31) in ADCs between group 2 and group 3. In addition, there were significant differences between osteosarcomas (1.40 +/- 0.28 x 10(-3) mm(2)/s) and inflammatory diseases (P = .038) and between osteosarcomas and carcinomas (1.11 +/- 0.26 x 10(-3) mm(2)/s; P = .035).
Diffusion-weighted MR imaging may be valuable in differentiating between benign solid lesions and malignant tumors in the masticator space. Inflammatory lesions cannot, however, be separated from most malignant tumors, except for osteosarcomas.
本研究旨在评估磁共振扩散加权成像在鉴别咀嚼肌间隙各种实性病变中的价值。
在手术和/或病理证实之前，对78例咀嚼肌间隙有病变的受试者进行了扩散加权回波平面磁共振成像检查。根据病理结果，将病变分为3组：第1组：良性肿瘤和肿瘤样病变（23例）；第2组：炎症性疾病（14例）；第3组：恶性肿瘤（41例）。从b值为0和1000 s/mm²的扩散加权磁共振图像中计算平均表观扩散系数（ADC）。采用Kruskal-Wallis检验和Mann-Whitney U检验对组间和病变类型间的差异进行统计学比较。
3组之间的ADC有显著差异（P = 0.0001），第1组（1.52±0.29[标准差]×10⁻³mm²/s）与第2组（1.01±0.31×10⁻³mm²/s）之间以及第1组与第3组（1.11±0.29×10⁻³mm²/s）之间均有显著差异。第2组和第3组之间的ADC无统计学显著差异（P = 0.31）。此外，骨肉瘤（1.40±0.28×10⁻³mm²/s）与炎症性疾病之间（P = 0.038）以及骨肉瘤与癌之间（1.11±0.26×10⁻³mm²/s；P = 0.035）有显著差异。
磁共振扩散加权成像在鉴别咀嚼肌间隙的良性实性病变和恶性肿瘤方面可能有价值。然而，除骨肉瘤外，炎症性病变无法与大多数恶性肿瘤区分开来。
