3D-ASL对舌肿物的诊断价值及与病理学特征的相关性分析

doi:10.19438/j.cjoms.2024.01.007

中国口腔颌面外科杂志 ›› 2024, Vol. 22 ›› Issue (1): 42-48.doi: 10.19438/j.cjoms.2024.01.007

3D-ASL对舌肿物的诊断价值及与病理学特征的相关性分析

鲁煜^1,*, 刘清海^2,*, 梁海胜^1#, 邓刚^3#

1.上海交通大学医学院附属第九人民医院放射科,上海 201999;
2.上海中医药大学附属龙华医院绩效管理部,上海 200032;
3.上海交通大学医学院附属第九人民医院口腔第二门诊部,上海 201999

收稿日期:2023-06-30 修回日期:2023-07-27 出版日期:2024-01-20 发布日期:2024-02-05
通讯作者: 梁海胜,E-mail: 196144659@qq.com;邓刚,E-mail: 75denggang@163.com。^#共同通信作者
基金资助:
黄浦区产业扶持基金（XK2020014）

Diagnostic value of 3D-ASL for tongue mass and its correlation with pathology

LU Yu¹, LIU Qing-hai², LIANG Hai-sheng¹, DENG Gang³

1. Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 201999;;
2. Department of Performance Management, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. Shanghai 200032;
3. Second Dental Center, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 201999, China;

Received:2023-06-30 Revised:2023-07-27 Online:2024-01-20 Published:2024-02-05

摘要/Abstract

摘要： 目的: 探讨3D动脉自旋标记灌注成像技术（3D arterial spin labeling,3D-ASL）、肿瘤血流（tumor blood flow,TBF）与舌部肿物组织病理学特征之间的相关性。方法: 前瞻性分析2019年12月—2021年12月上海交通大学医学院附属第九人民医院临床拟诊为舌部肿物的患者55例,术前均行颌面部常规MRI平扫、3D-ASL、扩散加权成像（diffusion-weighted imaging,DWI）和动态增强（dynamic contrast-enhanced,DCE）序列扫描。计算病灶的TBF,术后组织切片用CD34及Ki67染色以评估微血管密度（microvessel density,MVD）。利用SPSS 26.0软件中的Mann-Whitney U检验分析不同疾病间的TBF,以及TBF和MVD的相关性。结果: 舌异位甲状腺（ectopic thyroid,ET）在ASL的TBF伪彩图上均表现为整体红色的高灌注区（100%）,且高灌注的面积最大（100%）。舌鳞状细胞癌（squamous cell carcinoma,SCC）早期高灌注比例较高（13例,13/15,86.7%）。测量瘤体血流最大区域TBFmax、TBFmean、ADC值之间的差异具有统计学意义（P<0.05）。所有肿瘤中MVD与TBFmean、TBFmax呈强正相关（r_s=0.89、0.93,R²=0.70、0.84,P<0.01）。结论: 3D-ASL可无创评估舌部肿瘤血流,利于区别良、恶性肿瘤。SCC分级越高,高灌注出现越少,可反映出受肿瘤侵犯的程度。

关键词: 动脉自旋标记灌注成像技术, 舌鳞状细胞癌, 舌黏液表皮样癌, 舌异位甲状腺

Abstract: PURPOSE: To investigate the correlation between 3D arterial spin labeling (3D-ASL), tumor blood flow (TBF) and histopathological features of tongue masses. METHODS: A prospective analysis was performed in 55 patients with clinically probable tongue masses in Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from December 2019 to December 2021, and all of them underwent conventional maxillofacial MRI scanning, 3D-ASL, diffusion-weighted imaging(DWI) and dynamic contrast-enhanced (DCE) sequence scanning before surgery. TBF of lesions was calculated, and postoperative tissue sections were stained with CD34 and Ki67 to assess microvessel density (MVD). Mann-Whitney U test was used to compare and analyze TBF between different diseases, as well as the correlation between TBF and MVD with SPSS 26.0 software package. RESULTS: Ectopic thyroid(ET) showed an overall red hyperperfusion area (100%) on the TBF pseudocolor map of ASL, and the hyperperfusion area was the largest(100%). The proportion of hyperperfusion in early squamous cell carcinoma(SCC) was high(13 cases, 13/15, 86.7%). The difference between TBFmax, TBFmean, and ADC values in the largest region of tumor blood flow was statistically significant(P<0.05). MVD was strongly positively correlated with TBFmean and TBFmax in all tumors(r_s=0.89, 0.93, R²=0.70, 0.84, P<0.01). CONCLUSIONS: 3D-ASL can noninvasively assess tongue tumor blood flow and help distinguish benign and malignant tumors. The higher the SCC grade, the less hyperperfusion occurs, which reflects the degree of tumor invasion.

Key words: 3D arterial spin labeling perfusion imaging technique, Tongue squamous cell carcinoma, Tongue mucoepidermoid carcinoma, Tongue ectopic thyroid

中图分类号:

R739.8

鲁煜, 刘清海, 梁海胜, 邓刚. 3D-ASL对舌肿物的诊断价值及与病理学特征的相关性分析[J]. 中国口腔颌面外科杂志, 2024, 22(1): 42-48.

LU Yu, LIU Qing-hai, LIANG Hai-sheng, DENG Gang. Diagnostic value of 3D-ASL for tongue mass and its correlation with pathology[J]. China J Oral Maxillofac Surg, 2024, 22(1): 42-48.

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3D-ASL对舌肿物的诊断价值及与病理学特征的相关性分析

Diagnostic value of 3D-ASL for tongue mass and its correlation with pathology

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