Comparison of CT with MRI for the Evaluation of the Juxta-Oral Tumor
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 specificity 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 perineural tumor spreading.