Diffusionsgewichtete MRT zur Funktionsdiagnostik der Glandula submandibularis

Purpose: To investigate the feasibility of diffusion-weighted (DWI) echo-planar imaging (EPI) to depict the submandibular glands and to measure different functional conditions. Materials and Methods: Twenty-seven healthy volunteers were examined. Diffusion weighted sequence was performed prior to stimulation. Exactly 30 seconds after a commercially available lemon juice was given orally, the diffusion weighted sequence was repeated. All examinations were performed by using a 1.5-T superconducting system with a 30 mT/m maximum gradient capability and maximum slew rate of 125 mT/m/sec (Magnetom Symphony, Siemens, Erlangen, Germany). The lower part of the circularly polarized (CP) head coil and a standard two-element CP neck array coil were used. The flexibility of the neck array coil allowed positioning the N1 element (upper part of the coil) right next to the submandibular gland. The axial diffusion-weighted EPI (echo planar imaging) sequence was performed using a matrix of 119 x 128, a field of view of 250 x 250 mm (pixel size 2.1 x 1.95 mm), a section thickness of 5 mm with an interstice gap of 1 mm. The b factors used were 0 sec/mm(2), 500 sec/mm(2) and 1000 sec/mm(2). Apparent diffusion coefficiant (ADC) maps were digitally transferred to MRIcro (Chris Rorden, University of Nottingham, Great Britain). After detecting the submandibular glands a region of interest (RCII) was placed manually exactly within the boarder of both submandibular glands, excluding the external carotid artery on ADC maps. These procedures were performed on all ADC slices the submandibular glands could be differentiated in before and after oral stimulation. For statistical comparison of results, a student's t-test was performed with an overall two-tailed significance level of p = 0.05. Results: The visualization of the submandibular glands using the diffusion-weighted EPI sequence was possible in all of the 27 volunteers. Prior to oral stimulation an ADC of 1.31 x 10(-3) mm(2)/sec (95% CI, 1.39 x 10(-3) mm(2)/sec, 1.44 x 10(-3) mm(2)/sec) was calculated which increased to 1.41 X 10(-3) mm(2)/sec (95% KI, 1.39x 10(-3) mm(2)/ sec, 1.44 x 10(-3) mm(2)/sec) 30 seconds after stimulation. This increase proved to be significant (p < 0.001). Conclusion: Diffusion-weighted echo-planar MR imaging allows non-invasive quantification of functional changes in the submandibular gland.