| 许奇俊,邢振,陈潭辉,王峰,林成灿,曹代荣.MRI鉴别舌癌重建术后皮瓣与肿瘤复发[J].中国介入影像与治疗学,2024,21(11):675-679 |
| MRI鉴别舌癌重建术后皮瓣与肿瘤复发 |
| MRI for differentiating flaps and tumor recurrence after tongue cancer reconstruction |
| 投稿时间：2024-08-02 修订日期：2024-09-07 |
| DOI：10.13929/j.issn.1672-8475.2024.11.006 |
| 中文关键词: 舌肿瘤 外科皮瓣 肿瘤复发，局部 磁共振成像 |
| 英文关键词:tongue neoplasms surgical flaps neoplasm recurrence,local magnetic resonance imaging |
| 基金项目:福建省教育厅中青年教师教育科研项目（JAT200162）。 |
| 作者 | 单位 | E-mail | | 许奇俊 | 福建医科大学附属第一医院医学影像科, 福建 福州 350005
福建医科大学附属第一医院滨海院区国家区域医疗中心医学影像科, 福建 福州 350212 | | | 邢振 | 福建医科大学附属第一医院医学影像科, 福建 福州 350005
福建医科大学附属第一医院滨海院区国家区域医疗中心医学影像科, 福建 福州 350212 | | | 陈潭辉 | 福建医科大学附属第一医院医学影像科, 福建 福州 350005
福建医科大学附属第一医院滨海院区国家区域医疗中心医学影像科, 福建 福州 350212 | | | 王峰 | 福建医科大学附属第一医院医学影像科, 福建 福州 350005
福建医科大学附属第一医院滨海院区国家区域医疗中心医学影像科, 福建 福州 350212 | | | 林成灿 | 福建医科大学附属第一医院医学影像科, 福建 福州 350005
福建医科大学附属第一医院滨海院区国家区域医疗中心医学影像科, 福建 福州 350212 | | | 曹代荣 | 福建医科大学附属第一医院医学影像科, 福建 福州 350005
福建医科大学附属第一医院滨海院区国家区域医疗中心医学影像科, 福建 福州 350212 | dairongcao@163.com |
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| 中文摘要: |
| 目的 观察MRI鉴别舌癌重建术后皮瓣与肿瘤复发的价值。方法 回顾性纳入139例舌癌皮瓣重建术后患者，对比观察皮瓣与复发灶术后平扫及增强MRI表现。结果 术后随访期间，局部皮瓣于T1WI始终以等信号为主，于T2WI则5个月内以高信号、之后以等信号为主；游离皮瓣持续呈T1WI、T2WI混杂高信号，内可见条状、片状肌肉信号；复发灶持续呈稍不均匀T1WI等信号、T2WI高信号。皮瓣强化程度均逐渐减弱，复发灶则持续重度强化。皮瓣边界于术后5个月内以不清为主、≥13且＜74个月则以清楚为主，且体积有逐渐变小趋势，而复发灶边界持续不清。5个月内下颌舌骨肌及舌骨舌肌均以肿胀为主，之后均萎缩。术后5个月后术区见血肿、囊腔形成。复发灶位于皮瓣与残余舌组织交界处后下方，同侧或对侧下颌舌骨肌及舌骨舌肌边缘可见毛刺，可伴颈部淋巴结及远处转移。结论 MRI有助于鉴别舌癌重建术后皮瓣与肿瘤复发。 |
| 英文摘要: |
| Objective To observe the value of MRI for differentiating flaps and tumor recurrence after tongue cancer reconstruction. Methods Totally 139 patients after flap reconstruction for tongue cancers were retrospectively enrolled， and MRI manifestations of flaps and recurrence of tongue cancer were comparatively analyzed. Results During follow-up， local flaps mainly presented as equal signals on T1WI， high signals on T2WI within 5 months but then predominately as equal signals. Free flaps consistently showed mixed high signals on both T1WI and T2WI， with striated and sheeted muscle signals. The recurrent lesions consistently showed slightly inhomogeneous equal signals on T1WI and high signals on T2WI. The degree of enhancement of flaps gradually decreased， while the recurrent lesions continued to show severe enhancement. The margins of flaps were predominantly indistinct within 5 months after reconstruction， then became distinct in ≥13 while ＜74 months with smaller size than before， while recurrent lesions continued to show indistinct borders. The mylohyoid muscles and hyoglossus muscles predominantly swelled within 5 months after construction but then atrophied. Hematoma and cyst cavity in the operation area could be observed 5 months after construction. The recurrence lesions located in the lower and posterior junction part of flaps and the residual tongue tissue， spiculated margins could be found in the ipsilateral or contralateral mylohyoid muscles and hyoglossus muscles， as well as cervical lymph node and distant metastases. Conclusion MRI was helpful to differentiating flaps and recurrence lesions after tongue cancer reconstruction. |
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