摘要
目的探讨3.0T磁共振扩散加权成像联合动态增强磁共振成像对唾液腺肿瘤的诊断价值。方法回顾性分析37例唾液腺肿瘤患者的临床和MRI资料,所有患者均经穿刺活检或手术病理证实,观察病灶形态、边界、包膜、T1WI及T2WI信号特征,并测量分析病变的ADC值和TIC曲线。结果唾液腺多形性腺瘤的ADC值(1.75±0.32×10^(-3)mm^2/s)、唾液腺腺淋巴瘤的ADC值(0.78±0.09×10^(-3)mm^2/s)和恶性肿瘤的ADC值(1.12±0.21×10^(-3)mm^2/s)三者之间均存在统计学差异,唾液腺良性肿瘤与恶性肿瘤的ADC值分别为(1.32±0.57×10^(-3)mm^2/s)和(1.12±0.21×10^(-3)mm^2/s),两者无明显差异,腺淋巴瘤与恶性肿瘤的ADC阈值为0.83×10^(-3)mm^2/s,多形性腺瘤和恶性肿瘤的ADC阈值为1.38×10^(-3)mm^2/s;37例唾液腺肿瘤中,11例表现A型曲线,15例表现为B型曲线,10例表现为C型曲线,淋巴管瘤表现为D型曲线,腺淋巴瘤的Tpeak值(22.7±11.7)s与恶性肿瘤的Tpeak值(43.2±14.1)s之间存在统计学差异(P<0.01),腺淋巴瘤峰值时间早于恶性肿瘤;腺淋巴瘤廓清率(58.5%±7.4)高于恶性肿瘤廓清率(18.2%±12.1)(P<0.01),根据TIC曲线类型,其诊断的敏感性、特异性、准确率、阳性预测值及阴性预测值分别为88.9%、80%、86.5%、92.3%、72.7%;对于B型和C型曲线采用ADC值进行修正诊断后,各值分别为92.5%、90%、91.9%、96.2%、81.8%。结论磁共振ADC值和TIC曲线有助于唾液腺肿瘤性病变的诊断,TIC曲线表现为B型或C型时,联合应用ADC值有利于提高唾液腺肿瘤的定性诊断。
Objective To evaluate the diagnostic value of DWI combined with dynamic contrast-enhanced MR imaging of salivary gland tumor on 3.0T MR. Methods Thirty-seven cases of salivary gland tumors were all confirmed by biopsy or surgical pathology. Clinical materials as well as MRI were analyzed retrospectively. Emphasis was placed on the lesion morphology, borders, capsule signal intensity characteristics, ADC values and TIC types. Results The ADC values of pleomorphic adenomas （ 1.75 ± 0.32 × 10^-3 mm2/s）, adenolymphoma （0.78 ±0.09 × 10^-3 mm2/s） and malignant tumors （ 1.12 ±0.21 × 10^-3 mm2/s） were significantly significant. The ADC values between benign and malignant tumors of the salivary gland were not significanly different. The ADC value threshold between adenolymphoma and malignancies was 0.83 × 10^-3 mm2/s, and pleomorphic adenomas and carcinomas was 1.38 × 10^-3 mm2/s; Eleven cases＇ TIC were type A, 15 cases were type B, 10 cases were type C, lymphangioma was type D. There were significant differences between the Tpeak values of gland lymphoma （ 22.7 ± 11.7 ） s and malignancy （43.2 ± 14.1 ） s （ P 〈 0.01 ）. Adenolymphoma washout rate （58.5% ± 7.4） was higher than malignant tumors （ 18.2% ± 12. 1 ） （ P 〈0.01 ）. Taking the TIC type A, B and D as benign, the type C as malignant, the sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 88.9% , 80% , 86.5% , 92.3% , 72.7% , and Taking TIC type B and C combined with ADC value, the values were 92.5% , 90%, 91.9% , 96.2% , 81.8%. Conclusion ADC value and TIC types were useful in the diagnosis of salivary gland tumors. The combination of ADC values and TIC curve would improve the qualitative diagnosis when the TIC type was B or C.
出处
《医学影像学杂志》
2016年第7期1193-1198,共6页
Journal of Medical Imaging
关键词
唾液腺肿瘤
磁共振成像
动态增强
扩张散加权成像
Salivary gland tumor
Magnetic resonance imaging
Dynamic contrast-enhanced MR imaging
Diffusion-weighted imaging
