Development of made to order image diagnostic system for cervical metastaic lymph nodes in patients with oral cancer.

结果显示：1)STIR对颈部肿大淋巴结的显示率与CT相当；2)弥散加权背景信号抑制(DWIBS)对颈部肿大淋巴结的显示率优于CT。然而，DWIBS对诊断转移没有帮助。3)诊断为转移者的转移率为70.2%，诊断为“可能不是转移者”者为4.1%。超声诊断为反应性肿大淋巴结占4.1%。4)MRI T2加权像(T2WI)呈极高信号或高信号区，提示病变中有囊性变性或角质化。认为这些T2WI征象是转移性淋巴结的特异性征象。肿瘤细胞和纤维组织在MR图像上未见特异性征象。人们认为肿瘤细胞和正常淋巴组织之间的分化比较困难。5)我们开发的动态MRI小ROI方法比传统的ROI方法更适用于检测淋巴结内的肿瘤细胞。6)CT图像低密度区提示脂肪组织、出血、充血或滤泡增生。7)多普勒图上的淋巴结血管定量与牙齿和颌骨的炎症有关。8)开发了颈淋巴结影像报告系统，通过医院信息系统的局域网发送到约200台PC机上。

Results of this rematch is as fellows; 1) Detection ration of swelling cervical lymph nodes using STIR of MR imaging was equal to that of CT 2) Detection ration of swelling cervical lymph ncdes using Diffusion weighted whole body imaging with background signal suppression (DWIBS) was superior to that of CT. However, DWIBS was not useful for diagnosing metastasis. 3) Probability of metastasis was 70.2%in case of diagnosing as metastasis, 4.1% in case of diagnosing as “Perhaps, it was not metastasis. However, observation was necessary “and 4.1% in case of diagnosing as reactive swelling lymph node, using ultrasonography. 4) Very hyperintensity or hyperintensity area in T2 weighted image (T2WI) of MR imaging suggested cystic degeneration or keratinization in pathological fmdings. It was considered that these fmdings of T2WI were specific for matastatic lymph nodes. Tumor cells and fibrous tissue were not presented specific fmdings on MR images. It was considered that differentiation between tumor cell and normal lymphoid tissue was difficult. 5) Small ROI method of dynamic MRI, which was developed by us, was more useful for detecting tumor cells in lymph node than conventional ROI method. 6) It was considered that low attention area on CT images suggested fat tissue, hemorrhage, hyperemia or follicular hyperplasia. 7) I was suggested that vascular ration of lymph nodes on Doppler ultrasonograms depended on inflammation of teeth and jaw bones. 8) We developed imaging reporting system for cervical lymph node, which send to about200PCs through LAN of our hospital information system.