CT与MRI诊断下颌牙龈鳞状细胞癌下颌骨侵犯的对比研究OA
Comparison of CT and MRI for diagnosing mandibular invasion in gingival squamous cell carcinoma
目的:分析增强计算机断层扫描(CT)及核磁共振(MRI)评估对下颌牙龈鳞状细胞癌(gingival squa-mous cell carcinoma,GSCC)患者骨侵犯的诊断准确性,并探讨影响其诊断可靠性的临床病理特征.方法:选取 2023年 6 月～2025 年 7 月新疆医科大学第一附属医院口腔医院收治下颌牙龈鳞状细胞癌患者.每位患者术前均进行CT、MRI评估是否存在下颌骨骨侵犯.以病理检查结果作为金标准,分析CT及MRI检测下颌骨受累的敏感性、特异性、阳性预测值、阴性预测值和诊断正确性,此外,进一步探讨患者临床病理特征与 CT、MRI 诊断准确性的关联,为优化影像学诊断策略提供依据.结果:分析 40 例下颌牙龈鳞状细胞癌患者(病理确诊骨侵犯 18 例、未侵犯 22例),对比 MRI 与 CT 评估下颌骨侵犯的诊断效能,结果显示,MRI 的诊断准确率(77.5％vs.72.5％)、敏感性(88.9％vs.83.3％)、特异性(68.2％vs.63.6％)、阳性预测值(69.6％vs.65.22％)及阴性预测值(88.2％vs.82.4％)均高于CT,但两种方法与病理结果一致性均为中等(Kappa值:MRI=0.557,CT=0.458),两者差异无统计学意义(P>0.05);McNemar检验显示CT与MRI的诊断效能无统计学差异(P>0.05).MRI影像学表现与原发肿瘤位置(前/后牙区)及更高T分期显著相关(P<0.05),CT则无此关联.结论:MRI与CT诊断下颌牙龈鳞状细胞癌骨侵犯的效能相当,但MRI表现与肿瘤位置(前/后牙区)及T分期显著相关,具有更优的临床关联性,可为术前评估提供额外参考.
Objective:To evaluate the diagnostic accuracy of contrast-enhanced computed tomography(CT)and magnetic resonance imaging(MRI)in assessing bone invasion in patients with mandibular gingival squamous cell carcinoma(GSCC),and to explore the clinicopathological factors influencing their diagnostic reliability.Methods:Patients with man-dibular gingival carcinoma treated at the Stomatological Hospital of the First Affiliated Hospital of Xinjiang Medical University from June 2023 to July 2025 were enrolled.Preoperative CT and MRI scans were evaluated for the presence of mandibular bone invasion.Using pathological findings as the gold standard,the sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and overall diagnostic accuracy of CT and MRI in detecting mandibular involvement were analyzed.The influence of clinicopathological features on the diagnostic accuracy of both imaging modalities was also investi-gated.Results:This study analyzed 40 patients with mandibular GSCC(18 with pathologically confirmed bone invasion and 22 without).Comparison of the diagnostic performance showed that MRI had higher diagnostic accuracy(77.5％vs.72.5％),sensitivity(88.9％vs.83.3％),specificity(68.2％vs.63.6％),PPV(69.6％vs.65.2％),and NPV(88.2％vs.82.4％)than CT.However,both imaging techniques demonstrated moderate agreement with pathological results(Kappa:MRI=0.557,CT=0.458),with no statistically significant difference between CT and MRI(P>0.05).McNemar's test indicated no signif-icant difference in diagnostic outcomes between CT and MRI(P>0.05).Additionally,MRI findings were significantly associ-ated with primary tumor location(anterior/posterior region)and higher T stage(P<0.05),while no such correlation was ob-served with CT.Conclusion:MRI and CT exhibit comparable efficacy in diagnosing bone invasion in mandibular GSCC.How-ever,MRI findings show significant correlations with tumor location and T stage,providing superior clinical relevance and ad-ditional reference for preoperative evaluation.
吾塔别克·哈布力;吴旭彬;买买提吐逊·吐尔地
新疆医科大学第一附属医院(附属口腔医院)口腔颌面创伤正颌外科 新疆 乌鲁木齐 830054新疆医科大学第一附属医院(附属口腔医院)口腔颌面创伤正颌外科 新疆 乌鲁木齐 830054新疆医科大学第一附属医院(附属口腔医院)口腔颌面创伤正颌外科 新疆 乌鲁木齐 830054||新疆维吾尔自治区口腔医学研究所 新疆 乌鲁木齐 830054
医药卫生
下颌牙龈鳞状细胞癌骨侵犯磁共振成像计算机断层扫描诊断准确性
Mandibular gingival squamous cell carcinomaBone invasionMagnetic resonance imaging(MRI)Computed tomography(CT)Diagnostic accuracy
《临床口腔医学杂志》 2026 (2)
81-85,5
国家自然科学基金项目(82360198)
评论