定量动态增强MRI对泪腺恶性上皮性肿瘤及多形性腺瘤的诊断价值  

The value of quantitative dynamic contrast enhanced magnetic resonance imaging(DCE-MRI) for differential diagnosis between malignant epithelial tumors and pleomorphic adenoma of lacrimal gland

作　　者：陈月洁[1] 夏爽[2] 邹艳君[1] 张业[1] 丁泽[1] 

机构地区：[1]中国医科大学第八临床学院鞍钢总医院影像中心,鞍山114002 [2]天津市第一中心医院放射科,天津300192

出　　处：《磁共振成像》2015年第2期115-119,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的探讨定量动态增强MRI检查对泪腺恶性上皮性肿瘤及多形性腺瘤的诊断价值。材料与方法经病理证实的泪腺恶性上皮性肿瘤及多形性腺瘤共20例,其中多形性腺瘤8例,恶性上皮性肿瘤12例。3.0T动态增强MRI检查采用3D-T1WI ST序列进行动态增强扫描,获得定量参数:Ktrans(容量转移常数)、Kep(速率常数)、Ve(血管外细胞外间隙容积比)及动态曲线。检查对泪腺恶性上皮性肿瘤及多形性腺瘤组间的动态曲线比较采用卡方检验,采用Z检验评价良恶性上皮性肿瘤定量参数的差别,同时利用ROC曲线评价各参数的诊断效能。结果 TIC曲线中,多形性腺瘤呈速升平台型6例,速升缓降型2例。恶性上皮性肿瘤呈速升平台型3例,速升缓降型9例,组间比较有差异(P<0.05)。恶性上皮性肿瘤的Ktrans、Kep值显著高于多形性腺瘤的(Z=-2.533、-2.248,P<0.05)。Ktrans较Kep评价良恶性上皮性肿瘤更敏感,当Ktrans值为0.10时,其敏感度、特异度分别为91.9%和79.8%。结论定量动态增强参数Ktrans对于泪腺恶性上皮性肿瘤及多形性腺瘤具有一定的鉴别诊断作用。Objective： To evaluate the value of dynamic contrast enhanced magnetic resonance imaging（DCE-MRl） for differential diagnosis between malignant epithelial tumor and pleomorphic adenoma of lacrimal gland. Materials and Methods： DCE- MRI data of 20 patients with pathologically confirmed malignant tumor and adenoma of lacrimal gland were retrospectively analyzed. Eight were benign and 12 were malignant. DCE-MRI was analyzed with the pharmacokinetic model proposed by Tofts and Kermode. There were three DCE quantitative parameters： K^trans （volume transfer constant）, Kep （rate constant） and Ve （extravascular extracellular space volume ratio）. The dynamic curve was also analyzed. Z test was used to compare the different parameters between two groups.Chi-square test was used to analyze the difference of dynamic curves between groups. Receiver operating characteristic （ROC） curve was used to analyze the accuracy of parameters for differentiation of the two kinds of tumors. Results： Type of rapid washed in-platform was seen in 6 and 3 cases of pleomorphic adenoma and malignant tumor, respectively.Type of rapid washed inslowly washed out was seen in 2 and 9 cases of pleomorphic adenoma and malignant epithelial tumors.Value of K^rans, Kep in malignant tumor were significantly higher than those of adenoma （Z=- 2.533, - 2.248, P〈0.05）. K^rans is more sensitive than Kep to differentiate the pleomorphic adenoma and malignant epithelial tumors. When the cut off of K^rans is 0. 10, the sensitivity and specificity were 91.9% and 79.8%. Conclusions： K＇ has a certain role in differential diagnosis for malignant epithelial tumor andpleomorphic adenoma of lacrimal gland.

关 键 词：多形性腺瘤 泪腺恶性上皮性肿瘤 动态增强磁共振成像 泪腺 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.72[医药卫生—诊断学]