Original InvestigationThe Application of Dynamic Contrast-Enhanced MRI and Diffusion-Weighted MRI in Patients with Maxillofacial Tumors
Section snippets
Study Population
We investigated patients with untreated primary head and neck tumors who were referred to the Department of Oral Surgery and underwent DCE-MRI at our institute between April 2009 and October 2013. The institutional review board approved this study, and the requirement for informed consent was waived. Of the patients, one was omitted from this study because of poor images; therefore, 55 patients were enrolled in this study.
The characteristics of the patients (n = 55; 26 male and 29 female;
TK Model Analysis
Table 2 shows the mean Ktrans, ve, vp, Kep, and AUGC values for benign neoplasms (Pleo) and malignant tumors. Both Table 3 and Figure 1 present the results of the Steel-Dwass test performed to evaluate the parameters with significant differences between the four categories. Figure 2, Figure 3, Figure 4, Figure 5 show representative images of the four categories.
Pleo had lower Ktrans values compared to the malignant tumor (P = .0089) (Table 2). There was a significant difference between SCC and
Discussion
The malignant tumors had higher Ktrans values than the Pleo tumors (Table 2, Fig 1a). The Ktrans is determined according to both the permeability surface area product and tissue perfusion (blood flow) 24, 25. A lower Ktrans of the Pleo suggests a lower degree of permeability or a small blood flow. Moreover, the higher ve was also characteristic of Pleo.
Making the differential diagnosis between SCC (or MSGT) and ML was quite difficult based on the subjective TIC pattern classification. For
Conclusions
The Ktrans value of the Pleo was significantly smaller than that of SCC; however, it showed considerable overlap with those of the other two malignant tumors. Pleo has a characteristic large ve value, whereas ML has characteristically small ve values. Therefore, pharmacokinetic analyses are regarded to be an acceptable tool for making the differential diagnosis of lesions in the maxillofacial region.
Acknowledgments
This work was supported by an MEXT (Ministry of Education, Culture, Sports, Science and Technology) Grant-in-Aid for Scientific Research (C) 2 4 5 9 2 8 3 4.
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