3.0T磁共振功能成像对肾上腺良性嗜铬细胞瘤与乏脂腺瘤鉴别的价值评价  

Application of MR functional imaging in evaluation of lipid-poor adrenal adenomas and benign pheochromocytomas on 3.0 T

作　　者：于台飞 宋吉清[1,2] 蔡世峰[1,2] 袁宪顺[1,2] 

机构地区：[1]山东大学附属省立医院 [2]山东省医学影像学研究所,济南250021

出　　处：《中华临床医师杂志（电子版）》2011年第17期5041-5046,共6页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨3.0T磁共振功能成像对肾上腺良性嗜铬细胞瘤和乏脂腺瘤的鉴别价值。方法回顾性分析30例患者34个肾上腺良性嗜铬细胞瘤和乏脂腺瘤的化学位移成像及弥散加权成像,对肾上腺肿块的同反相位信号衰减值(SII)、肾上腺肿块-脾脏信号比(ASR)、表观扩散系数(ADC)值行散点图分析。采用Mann-WhitneyU法对两组间SII、ASR、ADC值进行统计学检验,并通过ROC曲线计算各种定量指标的最佳诊断阈值、敏感性、特异性及曲线下面积(AUC)。结果 22个良性嗜铬细胞瘤,SII平均为3.68%,ASR平均0.96,ADC值平均1.12×10-3mm2/s。12个乏脂腺瘤SII平均为27.74%,ASR平均0.75,ADC值平均1.10×10-3mm2/s。良性嗜铬细胞瘤和乏脂腺瘤的SII、ASR有统计学差异,但ADC值无统计学差异。ROC曲线分析显示,SII诊断乏脂腺瘤的最佳阈值为11.96%,AUC为0.841,其95%的可信区间为0.688～0.994。用SII为11.96%为标准,诊断乏脂腺瘤的敏感性为83.3%,特异性为81.8%。ASR诊断良性嗜铬细胞瘤的最佳诊断阈值为0.90,AUC为0.856,其95%的可信区间为0.698～1.014。用ASR为0.90为标准,诊断良性嗜铬细胞瘤的敏感性为86.4%,特异性为82.3%。结论 3.0T磁共振功能成像可用于肾上腺良性嗜铬细胞瘤、乏脂腺瘤诊断及鉴别诊断。Objective To explore 3.0 T MR appearances of lipid-poor adrenal adenomas and benign pheochromocytomas and to analyze the SII,ASR,and ADC value for diagnosis and differentiation.Methods To retrospectively evaluated 34 cases of lipid-poor adrenal adenomas and benign pheochromocytomas in 30 patients.Signal intensity index(SII),adrenal-to spleen ratio(ASR)and apparent diffusion coefficient(ADC)on chemical shift imaging and diffusion-weighted imaging were measured.A standard non-parametric test of two independent samples(Mann-Whitney U test)was used to analysis.Receiver operating characteristic(ROC)analysis was used to determine the optimal diagnosis threshold point,the sensitivity,specificity and area under the curve(AUC)were recorded or calculated.Results The mean SII,ASR and ADC value of lesions were listed below:benign pheochromocytomas(n=22):3.68%,0.96,1.12×10-3 mm2/s;lipid-poor adenomas(n=12):27.74%,0.75,1.10×10-3 mm2/s.There were significant differences between lipid-poor adenomas and benign phaeochromocytomas for SII and ASR.The optimal diagnosis threshold point of SII for lipid-poor adenomas was 11.96% by ROC curve analysis,and the sensitivity was 83.3%,specificity was 81.8%.The optimal diagnosis threshold point of ASR for benign phaeochromocytomas was 0.90 by ROC curve analysis,and the sensitivity was 86.4%,specificity was 82.3%.There was no significant difference for ADC values between benign pheochromocytomas and lipid-poor adenomas.Conclusions CSI and DWI are valuable for diagnosis and differentiation of lipid-poor.

关 键 词：磁共振成像 扩散加权成像 肾上腺肿瘤 

分 类 号：R736.6[医药卫生—肿瘤]