The Diagnostic Value Of MRI In Preoperative Staging Of Tongue Carcinoma

Objective:To study the diagnostic value of MRI in preoperative staging of tongue carcinoma.Materials and Methods :MR imaging information of 124 tongue carcinoma patients confirmed by surgery and pathology from january of 2013 to december of 2015 are reviwed.All patients underwent plain and contrast-enhanced MR scans.Imaging features including location, morphology,signal intensity,margin,maximal size,enhancement feature,lymph node,extent of invasion and distant metastasis are evaluated.According to International staging of tongue carcinoma,the consistency of evaluating the T staging,N staging and AJCC staging between MRI and pathology is analyzed by using Kappa test.Correlation between T staging and N staging is analyzed by using Spearman rank correlation analysis.There is statistical significance when value of p is less than 0.05.Results: 1.The location of tongue cancer includs:105 in body of tongue,10 in root of tongue,6 in body and root of tongue,3 in body of tongue with involvment of the mouth floor.The morphology of lesions is regular in 25 cases and irregular in 99 cases.106 cases show hypointensity,13 mild hypointensity and 5 isointensity on T1-weighted images.99 cases display hyperintensity,22 mild hyperintensity and 3 isointensity on T2-weighted images. The margin is well-defined in 43 cases and ill-defined in 81 cases.The maximal diameter of tumor is ranged from 0.7cm to 6.9cm with the average size of 2.7 cm.Homogeneous enhancement is seen in 63 cases,heterogeneous in 61 cases.Mild,moderate and obvious enhancement cases are 2,120 and 2 respectively.The involvement of lymph nodes is seen in 27 cases.The cases involving hyoglossus,styloglossus,palatoglossus,genioglossus and mylohyoid are 26,5,11,25 and 3 respectively.The hyoglossus can not be evaluated in 1 case. The involvment of genioglossus is suspected in 2 cases. There are 6 cases that involve mandible.1case shows pulmonary metastasis. 2.In the evaluation of the consistency between MRI and pathology,Kappa value of the T staging,N staging and AJCC staging is 0.783,0.564 and 0.732 respectively.The values of p are all less than 0.01 showing statistical significance. 3.To study the correlation between T staging and N staging on MRI with Spearman rank correlation analysis,the correlated coefficient is 0.25.The value of p is less than 0.01 showing statistical significance.Conclusion: 1.There is a good consistency between MRI and pathology in diagnosing preoperative staging of tongue carcinoma. MRI can be applicated in the diagnosing preoperative staging of tongue carcinoma. 2.In preoperative staging of tongue carcinoma with MRI, the higher T staging, the higher N staging.