摘要
目的:探讨基于磁共振DWI的表观扩散系数(ADC)和动态对比增强MRI(DCE-MRI)定量参数对良恶性软组织肿瘤的鉴别诊断价值。方法:回顾性分析经病理证实的46例软组织肿瘤患者的临床和MRI资料,其中良性组25例、恶性组21例。患者术前均行常规MRI、DWI和DCE-MRI(Tofts双室模型)检查,测量肿瘤的ADC平均值(ADC_(mean))、容量转移常数(K_(trans))、回流速率常数(K_(ep))和血管外细胞外间隙容积分数(V e)值。采用方差分析比较良、恶性软组织肿瘤组间各参数值的差异,并利用受试者工作特征曲线(ROC)分析各定量参数的诊断效能。结果:良、恶性软组织肿瘤组间ADC_(mean)、K_(trans)、K_(ep)和V_(e)值的差异均有统计学意义(P均<0.05)。ROC曲线分析结果显示,当K_(trans)阈值取0.1285/min,ROC曲线下面积最大(AUC=0.907),相应的诊断敏感度、特异度和符合率分别为82%、88%和85%。联合ADC_(mean)和K_(trans)时,AUC值为0.952,诊断敏感度为95%、特异度为88%,符合率提高至92%。结论:ADC平均值和DCE-MRI定量参数有助于鉴别软组织肿瘤的良恶性,单个参数中以K trans的诊断效能最佳,联合ADC_(mean)和K_(trans)能提高诊断准确性。
Objective:To investigate the value of apparent diffusion coefficient(ADC)in diffusion weighted imaging(DWI)and quantitative parameters in dynamic contrast enhanced-magnetic resonance imaging(DCE-MRI)for the differential diagnosis of benign and malignant soft tissue tumors.Methods:The clinical and MRI data of 46 cases with soft tissue tumors confirmed by surgery and pathology were retrospectively analyzed.There were 25 cases with benign tumors,and 21 cases with malignant tumors.All patients underwent regular MRI,DWI and DCE-MRI(using Tofts model)examination before surgery.The quantitative parameters including ADC mean,K trans,K_(ep)and V_(e)of each tumor were measured.Analysis of Variance was used to compare the difference of the four parameters between the two groups.Receiver operation characteristic(ROC)curve was used to evaluate the diagnostic efficacy of the four parameters.Results:There were statistically significant differences(all P<0.05)in ADC_(mean),K_(trans),K_(ep)and V_(e) between benign and malignant soft tissue tumors.ROC curve analysis showed that when the threshold value of K_(trans)was 0.1285/min,the AUC was 0.907,which was the maximum than the other three,with diagnostic sensitivity of 82%,specificity of 88%and accuracy of 85%.When K_(trans)were combined with ADC_(mean),the AUC was 0.952,the sensitivity was 95%,the specificity was 88%,and the accuracy was increased to 92%.Conclusion:The ADC and quantitative parameters of DCE-MRI are helpful to the differential diagnosis of benign and malignant soft tissue tumors.K_(trans) is of the best diagnostic efficacy as single parameter.The combination of ADC_(mean) and K_(trans) can improve the accuracy.
作者
宋伟
张禹
张茜
王肖
谭德力
骆祥伟
SONG Wei;ZHANG Yu;ZHANG Qian(Department of Medical Imaging,the 901th Hospital of Chinese PLA,Hefei 230031,China)
出处
《放射学实践》
CSCD
北大核心
2022年第4期498-503,共6页
Radiologic Practice
基金
安徽省重点研究与开发计划项目(1804h08020284)。
关键词
软组织肿瘤
磁共振成像
扩散加权成像
动态对比增强扫描
定量参数
Soft tissue tumors
Magnetic resonance imaging
Diffusion weighted imaging
Dynamic contrast enhanced scan
Quantitative parameters
