| ObjectiveTo evaluate the value of magnetic resonance diffusion-weighted imaging (DWI), combined with routine MRI, and apparent diffusion coefficient (ADC value) in laryngeal cancer diagnosis, differential diagnosis, degree of differentiation and stage.Materials and methodsThis study collected a total of 80 patients with laryngeal cancer, total 22 cases of patients with laryngeal benign disease,79 cases laryngeal cancer are confirmed by laryngeal biopsy or surgical pathology, one case of laryngeal cancer is confirmed by cervical lymph node biopsy as metastatic squamous cell carcinoma,who is clinically diagnosed as laryngeal cancer(T2N2M1) by laryngoscope and MR,he refused laryngeal biopsy and surgical treatment,because his PETCT shows that he has metastatic carcinoma of rib.All patients were performed routine MRI and DWI scans, and analysis of conventional MRI, DWI features and apparent diffusion coefficient (ADC) values. Compare to conventional MRI with conventional MRI combined DWI and ADC values in laryngeal cancer diagnosis accuracy and specificity, comparing the the average ADC values of laryngeal cancer with laryngeal benign disease,using ROC curve b1000 value under one of the best threshold for laryngeal cancer diagnosis, and calculated the sensitivity and specific degrees, comparing the average ADC values of different differentiation degrees of laryngeal cancer, using SPSS20.0 software, analyzing differences between ADC values in each group, the relationship between the clinical pathologic factors and the ADC using chi-square test, Fisher exact probability method, Logistic regression analysis as a multiple factors analysis, correlation analysis was performed using Pearson test.ResultGeneral clinical data of 80 cases of patients with laryngeal cancer (74 male and 6 female, the average age of 63.4 years (42～83 years); Intraoperative or preoperative pathological diagnosis:79 cases were squamous cell carcinoma,one case is neuroendocrine carcinoma.53(66.3%) cases were glottis carcinoma,23 cases (28.7%) were supraglottic carcinoma,3 cases (3.8%) were supraglottic carcinoma,l cases (1.2%) was transglottic carcinoma.68 patients (85.0%) had a history of smoking,55 (68.75%) patients had a history of drinking, with 53 patients smoking and drinking. Clinical stages:the stage 01 case (1.2%), stage 123 case (28.7%),stage Ⅱ35 case (43.7%), the stage Ⅲ 10 cases (12.5%), stage IV 11 cases (13.7%).Comparing the average ADC values of laryngeal cancer with laryngeal benign disease,and determine the laryngeal cancer diagnosis threshold ADC:75 cases of laryngeal cancer in DWI are characterized by high signal, the other 5 cases in DWI are nothing abnormal detected.ADC=1.4877±0.0601×10-3mm2/s.22 patients with laryngeal benign disease:11eases of DWI high signal (50%),11 cases (50%) of no obvious abnormal signal, ADC=2.2818±0.08077×10-3mm2/s, compared to both ADC values has obvious difference (p<0.001). The area under the ROC curve was 0.926, when 1.910×10O-3mm2/s,Youden index is 0.84 the diagnostic sensitivity and specificity are 100%,83.8%, respectively.Comparison of different differentiation degrees of laryngeal cancer average ADC values:well differentiation group ADC=1.7186±0.0904×10-3mm2/s, the moderately differentiation group ADC=1.2270±0.0612×10-3mm2/s, poorly differentiated group of ADC=1.2623±0.1150×10-3mm2/s, poorly differentiated group compare with moderately differentiation group and well differentiation group has no statistical significance (t=0.235,p=0.816),(t=1.865,p=0.069),moderately differentiated group compare with well differentiation group has statistical significance (t=4.216,p< 0.001).ConclusionDWI and quantitative index determination of ADC values were able to distinguish between laryngeal cancer and laryngeal benign disease. The average ADC values of advanced laryngeal cancer are higher than early laryngeal cancer’s, with the progress of the laryngeal cancer, the average ADC values showed a trend of gradually reduce. |
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