| Objective:To assess the quantification of three-dimensional (3D) properties of squamous cell carcinoma of tongue (TSCC) by measuring and analyzing the MR Images systematically. And to discuss about the feasibility of systematic measurement on MR Images in guiding the selection of surgical procedures.Material and methods:27 patients (22 males and 5 females) aged from 29～69 years (with an average age of 48.5 years) who were diagnosed with TSCC before the surgeries in Oral/Maxillofacial Surgery, Xiangya hospital were selected. All the patients had underwent preoperative clinical palpations and MRI examinations.8 linear parameters on MR Images of the three dimensions were selected to be measured, and 6 linear parameters were calculated through measurement which included:the distance between the front edge of the tumor and the tip of tongue (La), the distance between the trailing edge of the tumor and the lingual radix (Lp), length of tumor (L), the depth of tumor invasion (TM) and the distance between the tumor and the sublingual space (S). And 4 ratio parameters were also obtained through calculation, including:the respective ratio of La, Lp, L to the length of tongue body (La/L0, Lp/L0 and L/L0), and the ratio of W2 (the distance between the tumor and the septum of tongue) to half the width of the tongue (W2/W1). TM was compared with the depth of tumor invasion measured on the tongue right after the operation (TO) and that measured on the pathological section (TH). W2, Lp, S, as well as the related ratio parameters W2/W1 and Lp/L0 were compared with the results of palpation. The difference analysis of all the parameters were carried out based on cervical lymph node metastasis.Results:The mean value and standard deviation of 10 indexes were obtained through the measurement and calculation on MR Images:La was 18.81±13.39(mm), La/L0 was 40.99±28.81(%), Lp was -4.80±9.60(mm), Lp/L0 was -11.59±22.09(%), L was 29.70±15.90(mm), L /L0 was 67.98±38.93(%), TM was 19.13±7.53(mm), W2 was 4.54±9.12(mm), and W2/W1 was 16.07±38.98(%).A multiple comparison among TM, TO and TH was performed, which showed that there was no significant difference between TM and TO (P=0.470>0.05) and there was an linear correlation between them. Meanwhile, significant difference existed between TM and TH, as well as between TO and TH (P<0.05). And both of TM and TO had a linear correlation with TH. As for determining the boundary of the tumor, the degree of accuracy of MRI in determining whether cross the central line according to value W2, whether invade the lingual radix according to value Lp and whether invade the mouth floor according to value S were all higher than those through clinical palpation (P<0.05).As for predicting the rate of cervical lymph node metastasis, L and L/L0 of patients with cervical lymph node metastasis (37.70±15.26mm and 87.47±37.58%) were larger than L and L/L0 of who without (24.99±14.71mm and 56.52±35.94%), and the differences had statistical significance (P<0.05); The estimated rate of cervical lymph node metastasis was 18.8% when L≤30mm while the estimated rate was 63.64% when L>30mm, and the difference had a statistical significance (P<0.05).Conclusion:The linear and ratio data through systematic measurement and calculation based on MR Images can relatively accurately estimate the size, the depth of invasion as well as the range of TSCC. In addition, it also has a relative degree of accuracy in predicting the cervical lymph node metastasis. Therefore, MRI plays a guiding role in formulating the method selection of the surgery.
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