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Master Thesis

Cancers parotidiens : détection de l'extension périneurale au nerf facial en tractographie IRM

Abstract : Objectives: The objective of this prospective study was to determine whether MR tractography of the facial nerve (VIIn) is useful in detecting perineural spread (PNS) in parotid cancers. Methods: 30 patients with surgically managed parotid tumors (15 malignant, 15 benign tumors), who had undergone 3T-MRI with diffusion acquisition and post-processing constrained spherical deconvolution-based tractography, were included and compared with 15 healthy volunteers. The parameters of the diffusion-weighted sequences were b-value of 1000s/mm2, 32 directions. Two radiologists performed a blinded visual reading of tractographic maps and graded the VIIn average pathlength (AP) and fractional anisotropy (FA). We also compared diagnostic accuracy of tractography with morphological MRI sequences to detect PNS. Results: AP was significantly higher in cases with PNS (39.86mm [Quartile1: 36.27; Quartile3: 51.19]) versus cases without (16.23mm [12.90; 24.90]), p≤0.001. 27.36mm was the threshold above which there was a significantly association with PNS (Se:100%; Sp:84%; AUC: 0.96 IC95[0.904;1]). Intra- and interclass correlation coefficients were excellent (≈1). FA did not identify cases with PNS. Tractography maps visual analyses directly displayed PNS in distal neural ramifications with a sensitivity of 75%, versus 50% using morphological sequences. Conclusions: This study suggests that tractography could be used to identify VIIn PNS by parotid cancers.
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Master Thesis
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Submitted on : Wednesday, January 31, 2018 - 9:25:06 AM
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  • HAL Id : dumas-01599927, version 1


René-Charles Louis Rouchy. Cancers parotidiens : détection de l'extension périneurale au nerf facial en tractographie IRM. Médecine humaine et pathologie. 2017. ⟨dumas-01599927⟩



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