Yamada Ichiro, Yoshino Norio, Hikishima Keigo, Sakamoto Junichiro, Yokokawa Misaki, Oikawa Yu, Harada Hiroyuki, Kurabayashi Tohru, Saida Yukihisa, Tateishi Ukihide, Yukimori Akane, Izumo Toshiyuki, Asahina Shun
Department of Diagnostic Radiology and Nuclear Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Oral and Maxillofacial Radiology, Tokyo Medical and Dental University, Tokyo, Japan.
Magn Reson Imaging. 2018 Sep;51:69-78. doi: 10.1016/j.mri.2018.04.014. Epub 2018 Apr 26.
In this study, we aimed to determine the usefulness of diffusion kurtosis imaging (DKI) as a noninvasive method for evaluation of the histologic grade and lymph node metastasis in patients with oral carcinoma.
Twenty-seven patients with oral carcinoma were examined with a 3-T MR system and 16-channel coil. DKI data were obtained by a single-shot echo-planar imaging sequence with repetition time, 10,000 ms; echo time, 94 ms; field of view, 250 × 204.25 ms; matrix, 120 × 98; section thickness, 4 mm; four b values of 0, 500, 1000, and 2000 s/mm; and motion-probing gradients in three orthogonal directions. Diffusivity (D) and kurtosis (K) were calculated using the equation: S = S ∙ exp(-b ∙ D + b ∙ D ∙ K/6). Conventional apparent diffusion coefficient (ADC) was also calculated. The MR images were compared with the histopathologic findings.
Relative to the histologic grades (Grades 1, 2, and 3) of the 27 oral carcinomas, D values showed a significant inverse correlation (r = -0.885; P < 0.001) and K values showed a significant positive correlation (r = 0.869; P < 0.001), whereas ADC values showed no significant correlation (r = -0.311; P = 0.115). When comparing between metastatic and non-metastatic lymph nodes, significant differences in the D values (P < 0.001) and K values (P < 0.001), but not the ADC values (P = 0.110) became apparent.
In patients with oral carcinoma, DKI seems to be clinically useful for the evaluation of histologic grades and lymph node metastasis.
在本研究中，我们旨在确定扩散峰度成像（DKI）作为一种非侵入性方法用于评估口腔癌患者组织学分级和淋巴结转移的有效性。
27例口腔癌患者采用3-T磁共振系统和16通道线圈进行检查。通过单次激发回波平面成像序列获取DKI数据，重复时间为10000 ms，回波时间为94 ms，视野为250×204.25 ms，矩阵为120×98，层厚为4 mm，四个b值分别为0、500、1000和2000 s/mm，以及在三个正交方向上的运动探测梯度。使用公式S = S ∙ exp(-b ∙ D + b ∙ D ∙ K/6)计算扩散系数（D）和峰度（K）。还计算了传统的表观扩散系数（ADC）。将磁共振图像与组织病理学结果进行比较。
相对于27例口腔癌的组织学分级（1级、2级和3级），D值呈显著负相关（r = -0.885；P < 0.001），K值呈显著正相关（r = 0.869；P < 0.001），而ADC值无显著相关性（r = -0.311；P = 0.115）。在比较转移和非转移淋巴结时，D值（P < 0.001）和K值（P < 0.001）存在显著差异，但ADC值（P = 0.110）无明显差异。
在口腔癌患者中，DKI似乎在评估组织学分级和淋巴结转移方面具有临床应用价值。
