Sensitivity and specificity of magnetic resonance imaging in prediction of cervical lymph node metastasis in oral squamous cell carcinomas

Background: The inaccuracies in the clinical examination have been well-documented while advanced imaging modalities including computed tomography (CT) and magnetic resonance imaging (MRI) have been shown to have superior diagnostic accuracy in detecting occult and nodal metastasis. The aim of the present study was to identify as well as evaluate the inaccuracies in clinical examination and clinical diagnostic criteria in known cases of oral squamous cell carcinomas (OSCCs) with the help of MRI.

Methodology: A total of 24 patients attending as outpatients were included in the study while clinically diagnosed and histopathologically proven cases of OSCC were examined clinically and then, subjected to advanced imaging with the help of MRI. Statistical Analysis Used: Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA) while paired t-test was performed for evaluating the size of the tumour and lymph node recorded on clinical and imaging findings. p<0.05 was considered statistically significant.

Results: Detection of tumour size and lymph node metastasis were found to be higher in the case of MRI than when accomplished by clinical staging alone while paired t-test values for the difference in results were found to be statistically significant (p<0.05).

Conclusions: The present study showed that clinical diagnostic criteria alone were not sufficient and reliable for detecting metastatic lymphadenopathy highlighting the significance of advanced imaging modalities like MRI for an efficient pre-operative diagnostic workup as well as, as a tool for planning treatment in patients with OSCCs.

背景：临床检查的不准确性已有充分文献记载，而包括计算机断层扫描（CT）、磁共振成像（MRI）在内的先进影像学手段，在检测隐匿性转移及淋巴结转移方面展现出更优的诊断准确率。本研究旨在借助磁共振成像，识别并评估已知口腔鳞状细胞癌（OSCC）患者的临床检查及临床诊断标准所存在的误差。

研究方法：本研究共纳入24名门诊患者，选取经临床确诊且组织病理学证实的口腔鳞状细胞癌病例，先进行临床检查，随后行磁共振成像高级影像学检查。所用统计分析方法：采用社会科学统计软件包（SPSS）17.0版本（美国伊利诺伊州芝加哥市SPSS公司出品）开展统计分析，针对临床与影像学检查所得的肿瘤大小及淋巴结相关指标，采用配对t检验进行评估，以p<0.05为差异具有统计学意义。

结果：相较于单纯临床分期，磁共振成像对肿瘤大小及淋巴结转移的检出率更高，两组结果差异经配对t检验分析显示具有统计学意义（p<0.05）。

结论：本研究表明，单纯依靠临床诊断标准不足以且不可靠用于检测转移性淋巴结病变，凸显了磁共振成像等先进影像学手段在口腔鳞状细胞癌患者高效术前诊断评估及治疗方案规划中的重要价值。