Comparative analysis of preoperative MRI detection and clinical palpation examination in patients with oral and maxillofacial malignant tumor

This study aimed to investigate the effect of magnetic resonance imaging (MRI) and clinical palpation on the diagnosis of lymph node metastasis in patients with oral and maxillofacial malignant tumors. Patients with oral and maxillofacial malignant tumors were recruited (42 with tongue cancer, 30 with buccal cancer, and 25 with gingival cancer). The sensitivity, specificity, accuracy, positive predictive rate, and negative predictive rate for these three cancers were compared. The MRI sensitivity, specificity, accuracy, positive predictive rate, and negative predictive rate were 69.39 % 65.12 %, 62.96 %, 58.33 %, and 63.92 %, respectively. The clinical palpation sensitivity was 46.51 %, specificity was 74.07 %, accuracy was 61.86 %, positive predictive rate was 58.82 %, and negative predictive rate was 63.49 %. The sensitivity, specificity, accuracy, positive predictive rate, and negative predictive rate of the combined examination were 74.42 %, 75.93 %, 75.26 %, 69.57 %, and 80.39 %, respectively, which were significantly higher than those of clinical palpation and MRI ( P = 0.012). The sensitivity, accuracy, and negative predictive rate of MRI for tongue cancer patients were significantly higher than those of clinical palpation, while the specificity and positive predictive rate of MRI were significantly lower than those of clinical palpation ( P = 0.013). The specificity, accuracy, positive predictive rate, and negative predictive rate of MRI were significantly lower than those of clinical palpation ( P = 0.024), while those of gingival cancer patients reached 100 %, which was higher than that of clinical palpation ( P < 0.002). Clinical palpation significantly affected the diagnosis of lymph node metastasis in buccal cancer patients, while MRI significantly affected the diagnosis of lymph node metastasis gingival cancer patients. These findings provide evidence for clinicians in selecting diagnostic approaches, MRI and clinical palpation. MRI is recommended for gingival and tongue cancers, while clinical palpation remains valuable for buccal cancer. Combined examination enhances early detection of lymph node metastasis, supporting tailored treatment strategies.