Sridevi Koduri, Ila Anbu, Nagarajappa Anil Kumar, Rajan Meenakshi Sundaram Alaguvel, Kolte Deepak Ramesh, Gunturu Srikanth, Jandrajupalli Suresh Babu, Chandolu Swarnalatha, Nayyar Abhishek Singh
Department of Oral Medicine and Radiology, Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh, India.
Department of Dentistry, Panimalar Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India.
Niger Med J. 2021 Dec 10;62(1):14-22. eCollection 2021 Jan-Feb.
The inaccuracies in clinical examination have been well-documented while advanced imaging modalities including computed tomography (CT) and magnetic resonance imaging (MRI) have been shown to have superior diagnostic accuracy in detecting occult and nodal metastasis. The aim of the present study was to identify as well as evaluate the inaccuracies in clinical examination and of clinical diagnostic criteria in known cases of oral squamous cell carcinomas (OSCCs) with the help of MRI.
A total of 24 patients attending as outpatients were included in the study while clinically diagnosed and histopathologically proven cases of OSCC were examined clinically and then, subjected to advanced imaging with the help of MRI. Statistical Analysis Used: Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA) while paired t-test was performed for evaluating size of tumor and lymph node recorded on clinical and imaging findings. p<0.05 was considered statistically significant.
Detection of tumor size and lymph node metastasis were found to be higher in case of MRI than when accomplished by clinical staging alone while paired t-test values for difference in results were found to be statistically significant (p<0.05).
The present study showed that clinical diagnostic criteria alone were not sufficient and reliable for detecting metastatic lymphadenopathy highlighting the significance of advanced imaging modalities like MRI for an efficient pre-operative diagnostic work-up as well as, as a tool for planning treatment in patients with OSCCs.
临床检查的不准确性已有充分记录，而包括计算机断层扫描（CT）和磁共振成像（MRI）在内的先进成像方式已被证明在检测隐匿性和淋巴结转移方面具有更高的诊断准确性。本研究的目的是借助MRI识别并评估口腔鳞状细胞癌（OSCC）已知病例中临床检查及临床诊断标准的不准确性。
本研究共纳入24名门诊患者，对临床诊断并经组织病理学证实的OSCC病例进行临床检查，然后借助MRI进行先进成像。所用统计分析：使用社会科学统计软件包（SPSS）17.0版（美国伊利诺伊州芝加哥市SPSS公司）进行统计分析，采用配对t检验评估临床和影像学检查记录的肿瘤及淋巴结大小。p<0.05被认为具有统计学意义。
发现MRI检测肿瘤大小及淋巴结转移的情况比单纯临床分期更高，且结果差异的配对t检验值具有统计学意义（p<0.05）。
本研究表明，仅靠临床诊断标准不足以可靠地检测转移性淋巴结病，突出了MRI等先进成像方式对于有效的术前诊断评估以及作为OSCC患者治疗规划工具的重要性。
