Wang Jie, Tang Zuohua, Feng Xiaoyuan, Zeng Wenjiao, Tang Weijun, Wu Lingjie, Jin Lixin
From the *Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai; †Department of Radiology, Huashan Hospital of Shanghai Medical School, Fudan University, Shanghai, ‡Department of Pathology, Shanghai Medical School of Fudan University, Shanghai; and §Siemens Ltd. Healthcare Sector, Shanghai, China.
J Craniofac Surg. 2014 Nov;25(6):2147-51. doi: 10.1097/SCS.0000000000001142.
In this study, we evaluated the value of diffusion-weighted imaging (DWI) and magnetic resonance (MR) spectroscopy imaging (MRSI) combined with computed tomography (CT) and conventional MR imaging (MRI) in the diagnosis of Kimura disease (KD). The clinical data and CT and MRI findings of 5 patients with KD proven by histopathologic examination were retrospectively reviewed. Diffusion-weighted imaging and MRSI were performed at 1.5 T in 3 patients with KD. Apparent diffusion coefficient (ADC) values and the choline/creatine ratio of the lesions were compared with those of the contralateral normal parotid glands. All imaging results were compared with histopathologic findings. The typical features of KD were subcutaneous lesions, continuously infiltrative parotid lesions with or without intraparotid lymphadenopathies, and reactive cervical lymphadenopathies on CT and conventional MRI. On DWI, the ADC values of all subcutaneous and infiltrative parotid lesions were higher compared to those of normal parotid glands, and the ADC values of reactive lymphadenopathies were lower compared to both. The choline/creatine levels of subcutaneous and infiltrative parotid lesions were slightly higher than those of normal parotid glands. In conclusion, DWI and MRSI offer valuable information that may be characteristic of KD, which can highly suggest the diagnosis of KD when combined with morphological imaging.
在本研究中，我们评估了扩散加权成像（DWI）和磁共振（MR）波谱成像（MRSI）联合计算机断层扫描（CT）及传统磁共振成像（MRI）在木村病（KD）诊断中的价值。回顾性分析了5例经组织病理学检查证实为KD患者的临床资料以及CT和MRI表现。3例KD患者在1.5T条件下进行了扩散加权成像和MRSI检查。将病变的表观扩散系数（ADC）值及胆碱/肌酸比值与对侧正常腮腺进行比较。所有影像学结果均与组织病理学结果进行对比。KD的典型特征在CT和传统MRI上表现为皮下病变、腮腺持续浸润性病变伴或不伴腮腺内淋巴结肿大以及反应性颈部淋巴结肿大。在DWI上，所有皮下及浸润性腮腺病变的ADC值均高于正常腮腺，而反应性淋巴结肿大的ADC值低于两者。皮下及浸润性腮腺病变的胆碱/肌酸水平略高于正常腮腺。总之，DWI和MRSI提供了可能具有KD特征的有价值信息，与形态学成像相结合时可高度提示KD的诊断。
