磁共振影像檢查對口腔癌頸部淋巴結轉移的診斷價值
Diagnostic Value of Magnetic Resonance
Imaging in Cervical Node Metastasis from Oral
Cavity Cancer
黃清浩;陳榮邦;詹光裕
摘要 為了解磁共振影像檢查對頸部淋巴結是否遭受惡性腫瘤細胞轉移的診斷價值，我 們回溯性地收集了自民國 79 年 7 月至 83 年 6 月間，在孫逸仙醫院耳鼻喉科之 21 例口腔癌病例。所有的病人均於接受頭頸部磁共振影像檢查後，施行原發部 位及總共 22 側的頸部廓清術。我們比較術前之理學檢查，術前之磁共振影像檢 查及術後之病理檢查結果，發現在 22 例頸部的術前檢查中，理學檢查之正確率 為 77.3%(17/22)，磁共振影像檢查之正確率為 86.4%(19/22)，以磁共振影像檢查 共有 2 例偽陰性及 1 例偽陽性。我們認為磁共振影像檢查用來偵測口腔癌病患之 頸部淋巴結是否有腫瘤細胞之轉移，診斷之正確率優於理學檢查，但是仍不可能 完全正確。頸部淋巴結是否有惡性細胞之轉移，仍須靠組織病理學作最後的判讀。 AbstractIn order to assess the diagnostic value of magnetic resonance image (MRI) in neck lymph node status, a retrospective study was conducted. Between July 1990 and June 1994, in the Department of Otolaryngology, Sun Yat-Sen Cancer Center, 21 histologically proved oral cavity cancer patients were included in this study. After thorough physical examination and MRI study of head and neck region, 22 neck dissections were performed. A comparison was made between preoperative physical examination, preoperative MRI study and postoperative histological examination result. The accuracy rate for physical examination was 77.3% (17/22) and that for MRI was 86.4% (19/22). There were 2 false negative cases and one false positive case by MRI study. We concluded that MRI is superior to physical examination in the diagnosis of cervical metastasis from oral cavity cancer. However, it is impossible to make an exact diagnosis with MRI study alone. The final diagnosis of neck lymph node status still depends on pathological study.
