CAJ | 학술논문

目的探讨利用MR DWI评价不同生理状态下涎腺功能的可行性.方法对30例涎腺功能正常的鼻咽癌患者行DWI EPI扫描,b值取0、400、600、800、1000s/mm2.先于静息状态下对腮腺及颌下腺各扫描1次,然后给患者含服维生素C 100 mg×6片,于酸刺激状态下重复对腮腺扫描7次,每次间隔18 s.比较静息状态下腮腺和颌下腺ADC值的差别,以及酸刺激前后腮腺ADC值的变化.采用配对t检验对两组间数据进行比较.结果静息状态下,腮腺的ADC值[(1.23±0.12)×10-3mm2/s]显著低于颌下腺[(1.34 ±0.07)×10-3mm2/s,t=4.545,P＜0.01].酸刺激后第1次扫描腮腺ADC值为(1.41±0.19)×10-3 mm2/s,高于静息时基值(t=10.254,P＜0.01).随后ADC值在基值上波动,酸刺激后ADC的最小值为(1.24±0.14)×10-3 mm2/s,与基值比较差异无统计学意义(t=1.329,P＞0.05)；最大值为(1.49±0.20)×10-3mm2/s,7次扫描的平均值为(1.36±0.17)×10-3 mm2/s,均与基值比较差异有统计学意义(t值分别为15.127、l1.905,P值均＜0.01).结论 MR DWI通过ADC值的量化,可观察到不同生理状态下涎腺功能的变化.
목적 탐토이용MR DWI평개불동생리상태하연선공능적가행성.방법 대30례연선공능정상적비인암환자행DWI EPI소묘,b치취0、400、600、800、1000s/mm2.선우정식상태하대시선급합하선각소묘1차,연후급환자함복유생소C 100 mg×6편,우산자격상태하중복대시선소묘7차,매차간격18 s.비교정식상태하시선화합하선ADC치적차별,이급산자격전후시선ADC치적변화.채용배대t검험대량조간수거진행비교.결과 정식상태하,시선적ADC치[(1.23±0.12)×10-3mm2/s]현저저우합하선[(1.34 ±0.07)×10-3mm2/s,t=4.545,P＜0.01].산자격후제1차소묘시선ADC치위(1.41±0.19)×10-3 mm2/s,고우정식시기치(t=10.254,P＜0.01).수후ADC치재기치상파동,산자격후ADC적최소치위(1.24±0.14)×10-3 mm2/s,여기치비교차이무통계학의의(t=1.329,P＞0.05)；최대치위(1.49±0.20)×10-3mm2/s,7차소묘적평균치위(1.36±0.17)×10-3 mm2/s,균여기치비교차이유통계학의의(t치분별위15.127、l1.905,P치균＜0.01).결론 MR DWI통과ADC치적양화,가관찰도불동생리상태하연선공능적변화.
Objective To evaluate the function of the salivary glands with gustatory stimulation by using MR DWI.Methods A prospective study was conducted in 30 patients with nasopharyngeal carcinoma who had normal salivary function.A DWI sequence was performed on the salivary glands at resting state,and continually repeated on the parotid immediately after oral ascorbic acid stimulation over a period of 21 minutes (once every 18 seconds).The multiple b-values (0,400,600,800,1000 s/mm2) were used.ADC maps were evaluated with a manually placed region of interest including the entire salivary gland.The ADC of each gland was obtained by taking the mean of values on three contiguous sections containing the largest areas of the gland.The paired two-tailed Student t test was used to compare the ADC values of the parotid and the submandibular glands at rest,and of the parotid before and after stimulation.Results The mean ADC value at rest was significantly lower in the parotid [ (1.23 ±0.12) × 10-3 mm2/s] than in the submandibular glands [(1.34 ± 0.07 ) × 10 -3 mm2/s,t =4.545,P ＜ 0.01 ].After acid stimulation,the ADC value increased from the baseline to (1.41 ±0.19) × 10-3 mm2/s firstly and then fluctuated at the following time,with a peak value of ( 1.49 ± 0.20 ) × 10 -3 mm2/s and the average value of ( 1.36 ±0.17) × 10-3 mm2/s.The average value was significantly different from the baseline value (t =15.127,t =11.905,P ＜ 0.01 ).The minimum value [ ( 1.24 ± 0.14) × 10-3 mm2/s] was not significantly different compared to the baseline value (t =1.329,P ＞ 0.05 ).Conclusion MR DW1 can noninvasively evaluate the physiologic changes of salivary glands before and after acid stimulation.