摘要
目的探讨多回波Dixon技术和T_(2) mapping评价原发性干燥综合征(pSS)早期腮腺损伤的价值。方法前瞻性收集2018年12月至2019年12月郑州大学第一附属医院首次确诊为早期pSS的患者26例(pSS组),以及与之性别、年龄匹配的健康志愿者20名(对照组)。所有受试者均于治疗前行颌面部MRI平扫、DWI、多回波Dixon序列以及T_(2) mapping序列。分别测量pSS组和对照组双侧腮腺实质的ADC、脂肪分数(FF)和T_(2)值。采用配对样本t检验比较pSS组和对照组左侧与右侧腮腺各参数值的差异,采用独立样本t检验比较pSS组与对照组间腮腺各参数的差异。绘制ROC曲线评价各参数值对早期pSS的诊断效能,并采用DeLong检验对比各参数诊断效能的差异。应用二元logistic回归分析和ROC曲线评价3个参数联合对早期pSS的诊断效能。结果pSS组和对照组左侧与右侧腮腺的ADC、FF、T_(2)值差异均无统计学意义(P均>0.05)。pSS组腮腺的ADC值小于对照组(t=4.641,P=0.006),FF和T_(2)值均大于对照组(t=-2.910、P<0.001,t=-6.411、P<0.001)。采用ADC、FF、T_(2)值诊断早期pSS的ROC曲线下面积分别为0.666、0.750和0.862,三者联合的ROC曲线下面积为0.930,灵敏度和特异度分别为73.1%和97.5%。T_(2)值的ROC曲线下面积高于ADC值(Z=2.626,P=0.009)和FF值(Z=2.112,P=0.035),三者联合的ROC曲线下面积高于单独应用ADC、FF和T_(2)值(Z=4.869,P<0.001;Z=3.628,P<0.001;Z=2.162,P=0.031)。结论多回波Dixon序列和T_(2) mapping序列能够定量评价pSS早期腮腺脂肪沉积和炎性反应的特点,T_(2)值对pSS早期腮腺损伤的评价具有较大潜能,与FF和ADC值联合可进一步提高诊断效能。
Objective To assess the value of the parotid fat fraction(FF)and T_(2) relaxation time(T_(2) value)in the evaluation of early parotid involvment in patients with primary Sjögren′s syndrome(pSS)using multi-echo Dixon technique and T_(2) mapping imaging.Methods From December 2018 to December 2019,26 early pSS patients(pSS group)and 20 healthy controls(control group),matched to age and gender,were enrolled at the First Affiliated Hospital of Zhengzhou University in this prospectively study.All subjects underwent conventional MRI,DWI,multi-echo Dixon and T_(2) mapping sequences before treatment.The ADC,FF and T_(2) value of bilateral parotid parenchyma in pSS group and control group were measured respectively.Paired sample t test was used to compare the differences of ADC,FF and T_(2) values between left and right parotid glands for pSS group and control group,while independent sample t test was used to compare the differences of ADC,FF and T_(2) values between pSS group and control group.The ROC curves were drawn to evaluate diagnostic performance of ADC,FF and T_(2) values to distinguish early pSS,and the difference of diagnostic efficacy of each parameter was compared by Delong test.Binary logistic regression analysis and ROC curve were used to evaluate the diagnostic performance of the combination of the 3 parameters in early pSS.Results There were no significant differences of ADC,FF and T_(2) values between left and right parotid glands for pSS group and control group(all P>0.05).The parotid ADC values were significantly lower in pSS group than control group(t=4.641,P=0.006),while the FF and T_(2) values of pSS group were significantly higher than those of control group(t=-2.910,-6.411,both P<0.001).The areas under the ROC curve of ADC,FF and T_(2) values to distinguish early pSS were 0.666,0.750 and 0.862,respectively.The area under ROC curve of the combination of ADC,FF and T_(2) values was 0.930,with a sensitivity of 73.1%and a specificity of 97.5%.T_(2) values showed a better diagnostic efficacy than ADC
作者
张赞霞
李淑健
文宝红
张勇
汪卫建
张会霞
程敬亮
Zhang Zanxia;Li Shujian;Wen Baohong;Zhang Yong;Wang Weijian;Zhang Huixia;Cheng Jingliang(Department of MR,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2021年第12期1282-1286,共5页
Chinese Journal of Radiology
基金
河南省医学科技攻关计划(201602085)
国家自然科学基金(81871327)。
关键词
干燥综合征
腮腺
磁共振成像
对比研究
Sjögren′s syndrome
Parotid gland
Magnetic resonance imaging
Comparative study
