Department of Head and Neck Surgery of Cancer Institute of the State of Sao Paulo (ICESP), Brazil.
Department of Head and Neck Surgery, University of Sao Paulo School of Medicine, Brazil.
Oral Oncol. 2018 Mar;78:114-118. doi: 10.1016/j.oraloncology.2018.01.026. Epub 2018 Feb 20.
Suspicion of mandibular invasion directly influences perioperative strategy, requiring marginal or segmental mandibulectomy, or reconstruction in some cases. This has a considerable impact on outcome and quality of life. The aim of this study was to evaluate the accuracy of magnetic resonance and computed tomography in the prediction of mandibular invasion in patients with oral cavity cancer.
A systematic review was conducted, including diagnostic studies comparing magnetic resonance imaging with computed tomography in the prediction of bone invasion. Sensitivity, specificity, positive and negative likelihood values and summary receiver operating characteristic (sROC) curves were calculated.
The electronic and manual search identified 346 articles. Of these, 11 studies were included in the systematic review for a total of 477 patients. The sensitivity, specificity, and positive and negative likelihood values for MRI were 78%, 86%, 5.29 and 0.23, respectively. For CT, they were 76%, 89%, 6.00 and 0.28, respectively. The sROC curves for MRI and CT were 82.3% and 82.5%, respectively.
No superiority was observed between the diagnostic methods regarding mandibular invasion detection.
对下颌骨侵犯的怀疑直接影响围手术期策略，需要进行边缘或节段性下颌骨切除术，或在某些情况下进行重建。这对结果和生活质量有很大影响。本研究旨在评估磁共振成像和计算机断层扫描在预测口腔癌患者下颌骨侵犯中的准确性。
进行了系统评价，包括比较磁共振成像与计算机断层扫描在预测骨侵犯方面的诊断研究。计算了敏感性、特异性、阳性和阴性似然值以及汇总受试者工作特征（sROC）曲线。
电子和手动搜索共确定了 346 篇文章。其中，11 项研究被纳入系统评价，共纳入 477 例患者。MRI 的敏感性、特异性、阳性和阴性似然值分别为 78%、86%、5.29 和 0.23。对于 CT，它们分别为 76%、89%、6.00 和 0.28。MRI 和 CT 的 sROC 曲线分别为 82.3%和 82.5%。
在检测下颌骨侵犯方面，两种诊断方法之间没有观察到优势。
