摘要
目的:探讨体素内不相干运动扩散加权成像(IVIM)定量参数对鼻腔鼻窦肿物良恶性的鉴别诊断价值。方法:搜集本院33例经手术或病理证实的不同病理类型鼻腔鼻窦肿物,经普通MRI平扫及增强扫描后行IVIM扫描,选取病灶34个(良性18个,恶性16个),将测量的标准ADC(ADCstandard)、纯扩散系数(ADCslow)、假扩散系数(ADCfast)及灌注分数(f)与病理结果进行对照,比较各参数在良恶性肿物中的差异。使用单因素Logistic回归模型分析判断各参数是否具有独立诊断能力,应用受试者操作特征(ROC)曲线计算曲线下面积、良恶性诊断的阈值、敏感度、特异度及符合率,最后通过多因素Logistic回归模型分析得到参数联合诊断能力。结果:34个鼻腔鼻窦肿物中,良、恶性组(良性组去除息肉,恶性组去除血管外皮细胞瘤)各参数值分别为ADCstandard(1.419±0.355)×10-3 mm2/s、(0.866±0.267)×10-3 mm2/s,ADCslow(1.161±0.330)×10-3 mm2/s、(0.666±0.247)×10^(-3) mm^2/s,ADCfast(10.718±7.810)×10-3 mm2/s、(17.645±9.662)×10-3 mm2/s,f值(29.9±14.7)%、(22.2±13.3)%。良、恶性肿瘤的ADC_(standard)、ADC_(slow)、ADC_(fast)间差异具有统计学意义(P=0.000、0.000、0.027),f值差异无统计学意义(P=0.124)。ADC_(standard)和ADCslow具有独立诊断能力。各参数的ROC曲线下面积(AUC)、良恶性诊断阈值、敏感度、特异度及符合率分别为ADC_(standard):0.910、0.900×10^(-3) mm^2/s、94.4%、75.0%、85.3%,ADCslow:0.924、0.780×10-3 mm2/s、94.4%、87.5%、85.3%,ADCfast:0.760、10.116×10-3 mm2/s、75.0%、66.7%、73.5%。ADCslow及ADCfast联合诊断,AUC达0.931,诊断符合率达92.1%。结论:IVIM定量参数有助于鼻腔鼻窦肿物良恶性的鉴别诊断,ADCslow及ADCstandard联合可有效提高诊断的准确性。
Objective：To study the value of intravoxel incoherent motion（IVIM）quantity factors in the differential diagnosis of benign or malignant tumor in nasal cavity and paranasal sinues.Methods：In our hospital,33 cases had surgery or pathology proven nasal cavity and paranasal sinuses tumor with different pathology type were collected.All patients underwent routine non-enhanced,enhanced MR and IVIM scanning.34 lesions（18 benign tumors,16 malignant tumors）were chosen.The standard apparent diffusion coefficient（ADC（standard））,slow apparent diffusion coefficient（ADC（slow））,fast apparent diffusion coefficient（ADCfast）and the perfusion fraction（f）were correlated with pathology results between benign and malignant tumors.Using single-factor Logistic regression model to analyze the capacity of independent diagnosis,using receiver operating characteristic（ROC）curve to calculate the area under curve,threshold value of diagnosis between benign from malignancy,the sensitivity,specificity and accuracy.Finally,via multi-factor Logsitic regression model,the capacity of intergrated diagnosis could be acquired.Results：Of the 34 tumors in nasal cavity and paranasal sinues,polyps in benign group and hemangiopericytoma in malignant group were excluded.The ADC（standard）value in benign and malignant group was（1.419±0.355）×10^-3mm^2/s and（0.866±0.267）×10^-3mm^2/s respectively,the ADC（slow）value was（1.161±0.330）×10^-3mm^2/s and（0.666±0.247）×10^-3mm^2/s respectively,the ADCfastvalue was（10.710±7.810）×10^-3mm^2/s and（17.640±9.660）×10^-3mm^2/s respectively,the f value was（29.9±14.7）% and（22.2±13.3）%respectively.The ADC（standard）、ADC（slow）、ADCfastbetween benign and malignant tumors were significantly different（P=0.000、0.000、0.027 respectively）,yet no significant difference was showed in f value（P=0.124）.The ADC（standard）as well as ADC（slow）value had independent diagnostic capacity.The parameters included area under curve
作者
周艺默
唐维
任玲
黄砚玲
李松柏
ZHOU Yi-mo;TANG Wei;REN Ling(Department of Radiology,the First Hospital of China Medical University,Shenyang 110000,China)
出处
《放射学实践》
北大核心
2018年第7期674-678,共5页
Radiologic Practice
基金
辽宁省自然基金面上项目(2015020533)
关键词
磁共振成像
体素内不相干运动
诊断
鉴别
鼻肿瘤
Magnetic resonance imaging
Introvoxel incoherent motion
Diagnosis
differential
Nose neoplasms
