摘要
目的探索三维改良运动敏感平衡驱动(3D-iMSDE)脉冲MR神经成像序列对不同类型腮腺肿瘤、腮腺内面神经及腮腺导管的立体结构显示情况,以指导手术计划的制定.方法本研究为前瞻性研究.对30名健康志愿者及40例腮腺肿瘤患者分别进行3D-iMSDE序列、三维T2加权快速梯度回波(3D-T2-FFE)序列扫描.入组腮腺肿块患者均经颌面外科医师查体或经超声或其他影像检查发现.对志愿者iMSDE、T2-FFE序列显示的面神经主干与其一级分支及腮腺导管的显示情况独立评分.并比较两序列影像图上面神经及腮腺导管的信号强度比(SIR).对40例腮腺肿瘤患者,分析iMSDE及T2-FFE序列图像,比较两种方法对面神经及腮腺导管与肿瘤关系的显示情况,并与术中解剖所见及术后病理结果对照.对iMSDE及T2-FFE两序列的图像评分进行两样本Wilcoxon符号秩检验;对SIRN、SIRD分别进行配对样本t检验.两种方法显示面神经、腮腺导管及面神经、腮腺导管与肿瘤关系的比较采用χ^2检验.结果 30名健康志愿者双侧腮腺内面神经及腮腺导管的评分,在iMSDE序列上分别为(4.20±0.55)、(4.17±0.59)分,在T2-FFE序列上分别为(3.13±0.57)、(3.07±0.52)分, iMSDE序列图像评分均高于T2-FFE序列,差异具有统计学意义(Z=-6.197,P<0.05).面神经、腮腺主导管在iMSDE序列图像的SIR均高于T2-FFE序列,差异具有统计学意义(t值分别为10.772、11.586,P值均<0.05).40例腮腺肿瘤患者共41处病变,与术中解剖对比,iMSDE、T2-FFE序列显示面神经及其一级分支与肿瘤关系的正确率分别为87.8%(36例)、53.7%(22例),显示腮腺主导管与肿瘤关系的正确率分别为92.7%(38例)、73.2%(30例),两者差异均具有统计学意义(χ^2值分别为9.725、5.513,P值均<0.05).iMSDE序列中,36例面神经及其一级分支(颞面干、颈面干)与肿瘤的关系得以正确显示, 38例腮腺主导管显示结果较为理想.结论 3D-iMSDE MR神经成像序列�
Objective To investigate the spatial relationship between intraparotid facial nerve and parotid ducts in different types of parotid neoplasms with 3D improved motion-sensitized driven-equilibrium pulse (3D-iMSDE) MR neurography, and to guide the operation plan. Methods By means of prospective research methods, the sequences of 3D-iMSDE and 3D-T2-fast field echo (3D-T2-FFE) were obtained in 30 healthy volunteers and 40 patients with parotid gland tumors, respectively. All patients with parotid mass were found by physical examination, by maxillofacial surgeons or by ultrasonography or other imaging examinations. Facial nerve trunk with its first branches and parotid ducts were evaluated independently on images of iMSDE and T2-FFE sequence for volunteers. The signal intensity ratio (SIR) of both facial nerve and parotid ducts were compared respectively in two sequences The relationship between intraparotid facial nerve and parotid ducts with the lesion were analyzed on images of iMSDE and T2-FFE sequences for 40 patients. The results were compared with intra-operative anatomy and post-operative pathological findings.Wilcoxon symbolic rank test, t test and chi-square test were used Results The image scores of intra-parotid facial nerve and parotid ducts in iMSDE sequence were higher than that of T2-FFE sequence in all 30 healthy volunteers. The difference was statistically significant (Z=-6.197,P<0.05). Both the facial nerve and parotid duct on images of iMSDE sequence had higher SIR than that of T2-FFE. The differences were statistically significant (t=10.772,11.586, respectively;P<0.05). Forty patients with parotid gland tumors had a total of 41 lesions. Compared with the intraoperative anatomy, the accuracy of iMSDE and T2-FFE sequences in showing the relationship between the facial nerve and its primary branches with the mass were 36/41 (87.8%), and 22/41 (53.7%) respectively, and the accuracy of the two sequences in showing the relationship between the dominant duct of the parotid gland and the mass were 38/41 (
作者
蒋延伟
孙程
孙建
徐永通
张卫东
周伟
于连聘
李传亭
Jiang Yanwei;Sun Cheng;Sun Jian;Xu Yongtong;Zhang Weidong;Zhou Wei;Yu Lianpin;Li Chuanting(Department of Ultrasonography,Binzhou People's Hospital,Binzhou 256610,China;Binzhou Medical University Hospital,Binzhou 256603,China;Department of Maxillofacial Surgery,Shandong Provincial Hospital,Jinan 250021,China;Shandong Medical Imaging Research Institute,Shandong University,Jinan 250021,China;Shandong University)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2019年第9期755-760,共6页
Chinese Journal of Radiology
基金
山东省重点研发计划(2018GSF118041).
关键词
腮腺肿瘤
面神经
磁共振成像
腮腺导管
Parotid neoplasms
Facial nerve
Magnetic resonance imaging
Parotid duct
