三輪 邦弘¹, 湯浅 賢治¹, 岡村 和彦², 前田 顕之³

Kunihiro MIWA¹, Kenji YUASA¹, Kazuhiko OKAMURA², Akiyuki MAEDA³

¹福岡歯科大学全身管理・医歯学部門診断・全身管理学講座画像診断学分野, ²福岡歯科大学基礎医歯学部門生体構造学講座病態構造学分野, ³福岡歯科大学全身管理・医歯学部門口腔・顎顔面外科学講座口腔腫瘍学分野

¹Division of Oral & Medical Management, Department of Diagnostics & General Care, Section of Image Diagnostics, Fukuoka Dental College, ²Division of Biomedical Sciences, Department of Morphological Biology, Section of Pathology, Fukuoka Dental College, ³Division of Oral & Medical Management, Department of Oral & Maxillofacial Surgery, Section of Oral Oncology, Fukuoka Dental College

キーワード : cervical lymphnodes, texture analysis, complexity, metastasis, ultrasonography

目的：複雑度から算出した数値（modified complexity value: MCV）を利用して口腔癌における頸部腫脹リンパ節の内部エコー性状評価を行い，MCVがリンパ節転移と非転移とを区別する定量的な指標となるかを検討する．対象および方法：卵形超音波診断ファントムと病理学的に診断された頸部転移リンパ節27個，非転移リンパ節23個の計50個を対象として超音波画像を取得した．画像は256階調のグレイスケールであり，それを16階調像に再構成した．MCVは関心領域内の同一濃度の画素域周囲長の平方値をその画素面積で割って算出した．病変の確定診断は頸部廓清術後の病理組織で行った．結果および考察：MCVはファントム画像の描出条件を変化させてもほぼ同値を示した．リンパ節のMCVの合計値は非転移リンパ節よりも転移リンパ節で高値を示した．結語：MCVは口腔癌における頸部腫脹リンパ節の転移と非転移の鑑別に有用な指標であると考えられた．

Purpose: To evaluate the ultrasonographic internal architecture of enlarged cervical lymphnodes from oral carcinoma using the modified complexity value (MCV), and to determine if the modified complexity value is a valid diagnostic parameter for differentiating between metastatic and nonmetastatic lymphnodes. Subjects and Methods: An ellipsoid ultrasonographic phantom and 50 enlarged cervical lymphnodes (metastasis, 27; nonmetastasis, 23) were examined with a linear ultrasound scanner. Two hundred fifty-six grayscale images were reconstructed from the 16 grayscale images. Modified complexity value was calculated by dividing the square of the total length pixels by the total area of the images at the same density level in the region of interest. Definite diagnosis of the nodes was obtained by histologic examination after neck dissection. Results and Discussion: Modified complexity values under different conditions of the phantom did not differ from one another. The sum of the modified complexity values of the metastatic lymphnodes was higher than that of the nonmetastatic lymphnodes. Conclusion: The modified complexity value of the lymphnode ultrasonogram is a useful parameter for differentiating between metastatic and nonmetastatic enlargement in cervical lymphadenopathy in the oral carcinoma.