口腔颌面部腺样囊性癌的神经周围扩散：增强 CT 和 MRI 的评估。
Perineural spread of adenoid cystic carcinoma in the oral and maxillofacial regions: evaluation with contrast-enhanced CT and MRI.
机构信息
Department of Oral and Maxillofacial Radiology, Osaka Univeristy Graduate School of Dentistry, Japan.
出版信息
Dentomaxillofac Radiol. 2012 Feb;41(2):143-51. doi: 10.1259/dmfr/21825064.
OBJECTIVES
The objective of this study was to compare the accuracy of contrast-enhanced CT (CECT) and contrast-enhanced MRI (CEMRI) in the detection of perineural spread (PNS) of adenoid cystic carcinoma (ACC) in the oral and maxillofacial regions.
METHODS
This study consisted of 13 ACCs from 13 patients, all of which were histopathologically diagnosed. Both CECT and CEMRI were performed in all patients before the treatment. The images of each patient were retrospectively evaluated for the detection of PNS. The definitions of PNS included abnormal density/signal intensity, contrast enhancement or widening of the pterygopalatine fossa, palatine foramen, incisive canal, mandibular foramen and mandibular canal, and enlargement or excessive contrast enhancement of a nerve.
RESULTS
11 out of 13 cases were proven to exhibit PNS histopathologically. 8 of the 11 cases for which PNS was histopathologically proven exhibited PNS on MR images. Six of the eight cases for which PNS was exhibited on MR images also exhibited PNS on CT images. The sensitivity, specificity and accuracy for the detection of PNS were 55%, 100% and 62% on CT images and 73%, 100% and 77% on MR images, respectively. Although the accuracy of PNS on MR images was slightly superior to that on CT images, there were no statistically significant differences between the detection of PNS on CT images and on MR images.
CONCLUSIONS
CT and MR images are equally useful for the detection of PNS of ACC in the oral and maxillofacial regions.
目的
本研究旨在比较对比增强 CT（CECT）和对比增强 MRI（CEMRI）在检测口腔颌面部腺样囊性癌（ACC）神经周围侵犯（PNS）中的准确性。
方法
本研究纳入了 13 例经病理证实的 ACC 患者，每位患者均进行了 CECT 和 CEMRI 检查。对每位患者的图像进行回顾性评估，以检测 PNS。PNS 的定义包括异常密度/信号强度、对比增强或翼腭窝、腭孔、切牙管、下颌孔和下颌管增宽，以及神经增大或过度对比增强。
结果
13 例中有 11 例经病理证实存在 PNS。11 例中 8 例经病理证实存在 PNS 的患者在 MR 图像上显示 PNS。8 例中 6 例在 MR 图像上显示 PNS 的患者在 CT 图像上也显示 PNS。CT 图像对 PNS 的检测灵敏度、特异性和准确率分别为 55%、100%和 62%，MR 图像分别为 73%、100%和 77%。虽然 MR 图像上 PNS 的准确率略高于 CT 图像，但两种方法在检测 PNS 方面无统计学差异。
结论
CT 和 MR 图像在检测口腔颌面部 ACC 的 PNS 方面同样有用。
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