Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital, 5-1 Shikata-cho, 2-chome, Okayama 700-8525, Japan.
Eur J Radiol. 2012 Oct;81(10):2684-91. doi: 10.1016/j.ejrad.2011.11.005. Epub 2011 Dec 3.
To evaluate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for minor salivary gland tumors in the oral cavity.
Thirty-two patients with minor salivary gland tumors were examined preoperatively using DCE-MRI. Their maximum contrast index (CImax), time of CImax (Tmax), Tpeak; i.e., the time that corresponded to the CImax×0.90, and washout ratios (WR300 and WR600) were determined from contrast index (CI) curves. We compared these parameters between benign and malignant tumors and among the different histopathological types of minor salivary gland tumors. Then, we categorized the patients' CI curves into four patterns (gradual increase, rapid increase with high washout ratio, rapid increase with low washout, and flat).
Statistically significant differences in Tmax (P=0.004) and Tpeak (P=0.002) were observed between the benign and malignant tumors. Regarding each histopathological tumor type, significant differences in Tmax (P<0.001), Tpeak (P<0.001), and WR600 (P=0.026) were observed between the pleomorphic adenomas and mucoepidermoid carcinomas. It was difficult to distinguish between benign and malignant tumors using our CI curve classification because that two-thirds of the cases were classified into the same type (gradual increase).
The DCE-MRI parameters of minor salivary gland tumors contributed little to their differential diagnosis compared with those for major salivary gland tumors. During the diagnosis of minor salivary gland tumors, Tmax is useful for distinguishing between benign and malignant tumors.
评估动态对比增强磁共振成像(DCE-MRI)对口腔小涎腺肿瘤的诊断价值。
术前对 32 例小涎腺肿瘤患者进行 DCE-MRI 检查。从对比指数(CI)曲线中得出最大对比指数(CImax)、CImax 时间(Tmax)、Tpeak,即对应 CImax×0.90 的时间,以及洗脱比(WR300 和 WR600)。我们比较了这些参数在良性和恶性肿瘤之间以及不同组织学类型的小涎腺肿瘤之间的差异。然后,我们将患者的 CI 曲线分为四种类型(逐渐增加、快速增加且洗脱高、快速增加且洗脱低、平坦)。
Tmax(P=0.004)和 Tpeak(P=0.002)在良性和恶性肿瘤之间存在显著差异。对于每种组织学肿瘤类型,在 Tmax(P<0.001)、Tpeak(P<0.001)和 WR600(P=0.026)之间观察到多形性腺瘤和黏液表皮样癌之间存在显著差异。由于三分之二的病例被归入同一类型(逐渐增加),因此很难使用我们的 CI 曲线分类来区分良性和恶性肿瘤。
与大涎腺肿瘤相比,DCE-MRI 参数对小涎腺肿瘤的鉴别诊断贡献不大。在小涎腺肿瘤的诊断中,Tmax 有助于区分良性和恶性肿瘤。