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相關文獻
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頁籤選單縮合
題 名 | Comparison of CT with MRI for the Evaluation of the Juxta-Oral Tumor=電腦斷層和磁振造影檢查影像在口腔癌病患的評估 |
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作 者 | 施承貴; 陳啟昌; 陳文賢; 洪豪駿; 李三剛; | 書刊名 | 中華放射線醫學雜誌 |
卷 期 | 28:1 2003.02[民92.02] |
頁 次 | 頁1-8 |
分類號 | 416.14 |
關鍵詞 | 口腔癌; 電腦斷層; 磁振造影; Oral cancer; CT; MRI; |
語 文 | 英文(English) |
中文摘要 | 用影像檢查來對口腔腫瘤作定位和檢測腫瘤擴散範圍,在外科手術和放射治療的計劃上占有相當重要的地位,它能確切達到腫瘤的切除、決定放射治療範圍,進而改善病患預後的目的。本研究共有26例病患,包括13例口黏膜癌、10例舌癌、1例扁桃腺癌、1例軟顎癌和1例上頜竇癌。其中男性24位、女性2位,年齡由28歲至78歲(平均51.3歲)。有24名病患接受對比劑顯影電腦斷層檢查,全部26名病患均接受磁振造影檢查,檢查波序有T1為主、T2為主和注射顯影劑後影像。所有電腦斷層和磁振造影檢查影像以及手術後病理發現,均依照AJCC標準給予分期。影像檢查研究結果的分期,在對照手術病理分期發現,26例MRI檢查病患,有22例兩者分期相符占84.6%,而24例CT檢查病患則有13例占54.2%。針對腫瘤邊緣的界定,MRI比CT為佳的有13例占54.2%,兩者相同的有11例占45.8%。對於鄰近骨頭侵犯的偵測,MRI的敏感性達到100%、特異性為83.3%,而準確率為88.5%。在CT檢查的敏感性為71.4%、特異性為88.2%,而準確率則為83.3%。對於口腔癌,特別是口腔黏膜和舌頭部位腫瘤的分期,MRI比CT的準確性更高,尤其在腫瘤範圍的界定更為清楚。對鄰近骨頭組織的侵犯,雖然CT常能顯示骨皮質的破壞,但腫瘤對骨頭髓質的浸潤性侵犯和沿顱神經途徑的擴散方面,MRI卻比CT更為敏感,也因此更增高MRI對骨頭侵犯的診斷率。在口腔癌病患MRI已有逐漸取代CT檢查,提供更詳盡診斷資料之趨勢。 |
英文摘要 | In the juxta-oral tumor, imaging study to localize the size and extent of the primary tumor is critical in the planning of surgery and radiation therapy. It is helpful to ensure adequate resection of tumoral margin, determine radiation field and improve patient’s prognosis. Twenty-six juxta-oral tumor cases included 13 cases of buccal mucosa carcinoma (CA), 10 cases of tongues and/or mouth floor CA, 1 case of tonsil CA, 1 case of palate CA and 1 case of maxillary sinus CA. The study group consisted of 24 men and 2 women, aged from 30 to 75 years (mean, 51.3 years). Twenty-four contrast-enhanced CT images and 26 MRI examinations with T1WI, T2WI and post Gd-DTPA images were performed. The T-staging of CT, MRI and post-operation pathological findings were recorded according to American Joint Committee on Cancer (AJCC) criteria. Among 26 cases, the MRI gave an accurate staging in 22 cases (84.6%) and 13 out of 24 cases (54.2%) were staged correctly by CT scan. About the tumoral border delineation, the MRI is superior (13/24, 54.2%) or equal (11/24, 45.8%) to CT. The sensitivity for MRI to predict bony invasion by juxta-oral malignant tumors was 100%, the speci-ficity was 83.3%, and the accuracy was 88.5%. The sensitivity for CT scan to predict bony invasion was 71.4%, the specificity was 88.2% and the accuracy was 83.3%. MRI is more helpful than CT in evaluating the juxta-oral malignant tumors, especially the extent of tumor in the buccogingival and tongue region. The accuracy of T-staging in MRI for oral cancer is higher than CT. For the evaluation of bony invasion, contrast-enhanced CT is superior in demonstrating cortical bone invasion, while MRI is more sensitive in disclosing bone marrow involvement and per-ineural tumor spreading. |
本系統中英文摘要資訊取自各篇刊載內容。