摘要
目的探讨弥散加权成像(diffusion weighted imaging,DWI)、动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)多参数鉴别诊断腮腺Warthin瘤与多形性腺瘤的价值。材料与方法回顾性分析病理学证实的24例腮腺Warthin瘤患者共32个病灶、24例多形性腺瘤的MRI及临床资料。评估患者一般资料、表观弥散系数值(apparent diffusion coefficient,ADC)、T1初始信号强度值(previous signal intensity,SI_(pre))、增强后最大信号强度值(maximum signal intensity,SI_(max))、增强期末信号强度值(signal intensity of the end of enhancement,SI_(end))、达峰时间(time to peak,TTP)、廓清率(wash-out ratio,WR)及时间信号强度曲线(time intensity curve,TIC)类型。用受试者工作特征(receiver operating characteristic,ROC)曲线分析组间有统计学差异的参数对Warthin瘤与多形性腺瘤的鉴别诊断效能。结果 Warthin瘤发病年龄与多形性腺瘤不同,前者大于后者(t=9.33,P<0.05);男女比例不同,前者以男性为主,后者以女性多见(P<0.05)。Warthin瘤ADC值[(0.634±0.201)×10^(-3)mm^(2)/s]显著低于多形性腺瘤[(1.084±0.453)×10^(-3)mm^(2)/s](t=-5.00,P<0.05)。两者SI_(pre)(t=4.01,P=0.0002)、WR (t=15.10,P<0.0001)、TTP (P<0.05)及TIC类型(P<0.05)差异有统计学意义。以ADC值=0.811×10^(-3)mm^(2)/s为阈值,鉴别Warthin瘤与多形性腺瘤的AUC为0.845 (P<0.05),敏感度为83.3%,特异度为90.63%;TIC类型区分二者的AUC为0.961 (P<0.05),敏感度为95.45%,特异度为100%;ADC值与TIC类型联合区分二者的AUC为0.984(P<0.05),敏感度为100%,特异度为96.88%。结论 DWI、DCE-MRI多参数及联合有助于鉴别Warthin瘤与多形性腺瘤。
Objective:To investigate the value of multiparametric features including diffusion weighted imaging and dynamic contrast-enhanced MRI in differentiation between parotid Warthin tumor and pleomorphic adenoma(PA).Materials and Methods:Forty-eight patients were included in this study including 32 parotid Warthin tumors and 24 pleomorphic adenomas.Conventional and multiparametric MRI features were analyzed.Differences in conventional MRI features,ADCs,previous signal intensity(SIpre)、maximum signal intensity of enhancement(SImax)and signal intensity of the end of enhancement(SIend),wash-out ratio(WR),time to peak(TTP),and time-intensity curves(TICs)types between the two entities were determined byχ2 test and independent samples t-test.Receiver operating characteristic(ROC)curves of parameters being statistically different between groups were drawn for differential diagnosis of Warthin tumor and PA of parotid gland,and the corresponding diagnostic efficacy were analyzed.Results:The ages of Warthin tumors were significantly older than those of pleomorphic adenomas(t=9.33,P<0.05).The male to female ratios were significantly different between the two entities(P<0.05).The ADCs of Warthin tumors[(0.634±0.201)×10^(-3) mm^(2)/s]were significantly lower than those of pleomorphic adenomas[(1.084±0.453)×10^(-3) mm^(2)/s](t=-5.00,P<0.05).There were significant differences in SIpre(t=4.01,P=0.0002)、WR(t=15.10,P<0.0001)、TTP(P<0.05)and TIC types(P<0.05)between the two entities.Taking ADC=0.811×10^(-3) mm^(2)/s as threshold drawing ROC for differential diagnosis of Warthin tumor and PA of parotid gland,the area under the curve(AUC),sensitivity,specificity,were 0.845(P<0.05),83.3%,90.63%.Taking TIC types drawing ROC,the AUC,sensitivity,specificity,were 0.961(P<0.05),95.45%,100%.Taking ADCs combined with TIC types drawing ROC,the AUC,sensitivity,specificity,were 0.984(P<0.05),100%,96.88%.Conclusions:Multiparameters and combined parameters of DWI and DCE-MRI were helpful to differential diagnosis of Warthin tumor and pleomo
作者
胡涛
方学文
刘琼
邹玉坚
姚兆友
高云
张坤林
HU Tao;FANG Xuewen;LIU Qiong;ZOU Yujian;YAO Zhaoyou;GAO Yun;ZHANG Kunlin(Department of Radiology,Dongguan People's Hospital of Guangdong Province,Dongguan 523000,China;Department of Sub-health,Dongguan People's Hospital of Guangdong Province,Dongguan 523000,China;Department of Oral and Maxillofacial Surgery,Dongguan People's Hospital of Guangdong Province,Dongguan 523000,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2021年第7期55-59,共5页
Chinese Journal of Magnetic Resonance Imaging
关键词
腮腺
腺淋巴瘤
腺瘤
多形性
诊断
鉴别
磁共振成像
parotid gland
adenolymphoma
adenoma,pleomorphic
diagnosis,differential
magnetic resonance imaging
