目的:探讨术前MRI对口腔鳞状细胞癌(OSCC)治疗计划中舌骨肌(MM)浸润的预测特征的评估,定义最合适的序列,以研究其向口腔底部的深度延伸(FOM)。
方法:我们采用7分评分对接受OSCC手术超过11年的患者的术前影像学进行回顾性评估。使用Spearman秩系数将结果与组织病理学结果进行比较。受试者工作特征曲线用于评估评分预测MM浸润的能力,确定灵敏度的最佳阈值,特异性,和预测值。Mann-WhitneyU检验证实,渗透判断在此阈值附近没有重叠。Cohen的K统计系数用于评估观察者之间的一致性。
结果:52例患者(平均年龄66.4±11.9岁,36名男性)进行了评估。组织病理学检查发现21%的病例(n=11)有MM浸润,90%被归入得分最高的类别。分数>4被证明是预测MM渗透风险的最佳截止值,灵敏度为91%(CI:0.57-0.99),特异性61%(CI:0.45-0.76),PPV38%(CI:0.21-0.59),和净现值96%(CI:0.78-0.99)。在随后的单序列评估中,TSE-T2wi的诊断准确率最高,灵敏度为90%(CI:0.57-0.99),特异性70%(CI:0.53-0.82),PPV45%(CI:0.25-0.67),和净现值96%(CI:0.80-0.99)。
结论:7分评分是OSCC治疗中MM安全手术切缘的有希望的预测指标,具有T2加权序列的特殊好处。
结论:我们的MM肿瘤浸润评分系统,即使对于经验不足的放射科医生来说也很容易使用,允许放射学语言的一致性,从而为外科医生确保重要的术前信息。
结论:MM与口腔病变的关系可能影响手术计划。随着分数的增加,MM中渗透的发生率更高。我们的评分系统改善了放射科医生对肿瘤累及MM的报告。
OBJECTIVE: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).
METHODS: We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman\'s rank coefficient. Receiver operating characteristic curves were employed to assess the score\'s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann-Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen\'s K statistical coefficient was used to evaluate the interobserver agreement.
RESULTS: Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57-0.99), specificity 61% (CI: 0.45-0.76), PPV 38% (CI: 0.21-0.59), and NPV 96% (CI: 0.78-0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57-0.99), specificity 70% (CI: 0.53-0.82), PPV 45% (CI: 0.25-0.67), and NPV 96% (CI: 0.80-0.99).
CONCLUSIONS: The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.
CONCLUSIONS: Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.
CONCLUSIONS: The relationship of the MM to an oral lesion may impact surgical planning. As the score increases, there is a greater incidence of infiltration in the MM. Our score system improves radiologists\' reporting for MM involvement by tumor.