Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Oral Radiol. 2023 Apr;39(2):235-241. doi: 10.1007/s11282-022-00626-x. Epub 2022 Jun 11.
To determine the magnetic resonance imaging (MRI) features of methotrexate-related lymphoproliferative disorder (MTX-LPD) in the oral cavity of a patient with a chief complaint of oral symptoms.
We included six patients who visited our hospital between November 2014 and November 2019, histopathologically diagnosed with MTX-LPD. All images were examined using 3 T MRI and reviewed by two radiologists.
Masses were detected in five cases; all masses demonstrated signal hypointensity and homogeneous signal hyperintensity on T1- and T2-weighted images with fat suppression. Homogeneous enhancement with fat suppression was evident on post-contrast T1-weighted imaging. We performed dynamic contrast-enhanced MRI in three cases and observed early enhancement with a low washout ratio pattern in all cases. Four patients underwent diffusion-weighted MRI and revealed low mean apparent diffusion coefficient (ADC) of 0.57 (range 0.5-0.65) × 10 mm/s.
We reported on the imaging characteristics of six rare cases of MTX-LPD in the oral cavity. Homogeneous hyperintensity on fat-suppressed T2-weighted images and low ADC values are possible features of MTX-LPD. Moreover, MTX-LPD can be differentiated from other carcinomas in the oral cavity.
探讨以口腔症状为主诉的患者甲氨蝶呤相关性淋巴组织增生性疾病（MTX-LPD）的磁共振成像（MRI）特征。
回顾性分析 2014 年 11 月至 2019 年 11 月期间在我院就诊、经组织病理学诊断为 MTX-LPD 的 6 例患者的临床及 MRI 资料。所有图像均采用 3.0T MRI 扫描，由 2 名放射科医师进行阅片。
5 例患者表现为口腔内肿块，T1 及 T2 加权像均呈低信号，抑脂序列呈均匀高信号，增强后呈均匀强化；3 例行动态增强 MRI 检查，均呈早期强化且廓清率低的模式；4 例行弥散加权成像（DWI），平均表观弥散系数（ADC）值为 0.57（范围 0.5~0.65）×10mm/s。
本文报道了 6 例口腔 MTX-LPD 的 MRI 表现，病灶在抑脂 T2 加权像上呈均匀高信号、ADC 值低，有助于与口腔其他恶性肿瘤相鉴别。
