The Application Of 1.5T Magnetic Resonace Diffusion Weighted Imaging In Tongue Carcinoma

Object:Diffusion-weighted MRI?DWI?has been introduced in head and neck lesions and adds important information to the findings obtained through conventional MRI.The purpose of this study was to evaluate the application value and correlation of the diagnosis,differential diagnosis,pathological grading,staging and treatment of tongue carcinoma in the magnetic resonance diffusion weighted imaging.Materials and methods:Collected a total of 20 patients with benign lesions of tongue;tongue cancer patients in 60 cases,including 2 cases of tongue cancer patients by biopsy and MRI diagnosis of lymph node metastasis to the near mandible to give up treatment;2 cases of tongue cancer patients choose radiotherapy conservative treatment;the remaining 56 cases of tongue cancer patients underwent tongue cancer confirmed by biopsy or surgical pathology.60 cases of tongue cancer patients in 1 cases of adenoid cystic carcinoma,59cases of squamous cell carcinoma.60 cases of tongue cancer patients and 20 benign lesions of tongue of patients before treatment were examined with conventional MRI and DWI scanning,analysis of conventional MRI and DWI imaging features:?1?.The average ADC value measurement of tongue lesions,and ROC curve is used to obtain the best threshold of tongue diagnosis,and then calculate its specificity and sensitivity;?2?.Comparison of different tongue cancer T staging of the average ADC value;?3?analysis.The correlation between different pathological grading and tongue ADC value;?4?.Correlation analysis between benign and malignant lymph nodes with ADC value.Using SPSS 20 software,ADC value was expressed by mean plus or minus standard deviation.The independent samples t test was used between the two groups.The three groups were compared by one-way ANOVA.When P value<0.05 appeared,22 groups were compared by LSD test.The ROC curve was used to determine the value of ADC as a diagnostic value for benign and malignant lesions of the tongue.The best threshold and corresponding sensitivity,specificity and area under the curve were calculated.There was a statistically significant difference between the p<0.05 levels.Results:1.Conventional MRI findings:In 60 cases of tongue cancer,45 cases of T1WI showed low signal,15 cases of T1WI showed equal signal,T2WI showed 60 cases were all high signal,60 cases of tongue cancer patients 55 cases were diagnosed as tongue malignant tumor,and the sensitivity was about 91.7%.There were 38 cases of cervical lymph node enlargement and 10 cases of cervical lymph node metastasis.2.Compare the average ADC value of tongue cancer and benign tongue lesions and determine the best threshold:60 cases of tongue cancer DWI were high signal,ADC=1.19±0.17x10^-3mm²/s;20cases of benign lesions in ADC=1.54±0.15 x10^-3mm²/s,compared with both ADC values had significant difference?t=-7.919,p<0.05?,b=800s/mm²,the area under the ROC curve?area under the ROC curve,AUC?is 0.928,when the ADC is 1.34x10-3mm2/s.The maximum Youden index is about 0.7833,so to determine the threshold value of1.34x10^-3mm²/s,the diagnostic sensitivity and specificity are respectively 88.3%?90%.3.ADC value and tongue carcinoma T stage.The ADC value of the early tongue cancer?Tis+T1+T2?in the 60 cases of tongue cancer was 1.23±0.16x10^-3mm²/s,the ADC value of the advanced tongue cancer?T3+T4?was 1.04±0.17x10^-3mm²/s,and the ADC value in the advanced tongue cancer was significantly lower than that in the early tongue cancer?t=3.708,p<0.05?.T1 and T3?T4respectively to compare,the difference was statistically significant?p value were 0.007,0.002?,T2 and T3?T4,difference was statistically significant?p value were 0.040,0.010?,the other two is no significant difference?p>0.05?,illustrate the ADC values have gradually reduce the trend with the progress of the tongue cancer.4.Application value of ADC value in the pathological differentiation grading of tongue carcinoma:This study,in high differentiation group of 11 cases with tongue cancer and differentiation in the group of 38 cases,11 cases poorly differentiation group,high tongue cancer differentiation group of ADC values were 1.36±0.11x10^-3mm²/s,differentiation group of ADC were 1.20±0.15x10^-3 mm²/s,and poorly differentiation group of ADC were 0.97±0.07x10^-3 mm²/s,,the comparison between the three groups,the F value is 26.000,and p<0.05;Compared with the low differentiation group,p<0.05;the high differentiation group was compared with the middle differentiation group,p<0.05;the low differentiation group was compared with the middle differentiation,and p<0.05.The differences between the two groups were statistically significant.5.Application of ADC value in tongue carcinoma lymph node metastasis and non-lymph node metastasis:There are a total of 38 cases in 60 patietents with tongue cancer found in patients with cervical lymph node enlargement,pathological results 10 cases of metastatic lymph node average ADC values is about 0.99±0.16 x10^-3 mm²/s,28 cases without metastatic lymph nodes average ADC values of 1.14±0.18x10^-3mm²/s,compared two groups,t=1.895,p=0.066 had no significant difference?P>0.05?.Conclusion:1.The value of DWI and ADC can be of great value in the diagnosis and differential diagnosis of tongue cancer and benign tongue lesions;2.when b=800s/mm²,ADC=1.34X10^-3mm²/s is the best threshold for diagnosis of benign and malignant tongue;3.ADC value in advanced tongue carcinoma is significantly lower than that of early tongue cancer,and ADC value decreases with the progression of tongue cancer;4.The value of ADC is of great value in the pathological grading of tongue cancer.