DWI在眼眶良恶性病变鉴别诊断中的应用  

Diffusion-Weighted Imaging in Differentiating Benign and Malignant Lesions of the Orbit

作　　者：郭亚飞[1] 程敬亮[1] 张勇[1] 张春艳[1] 汪卫建 

机构地区：[1]郑州大学第一附属医院磁共振科,450052

出　　处：《临床放射学杂志》2017年第5期630-633,共4页Journal of Clinical Radiology

摘　　要：目的探讨扩散加权成像(DWI)和表观扩散系数(ADC)值在诊断及鉴别诊断眼眶良恶性病变中的价值。方法对78例眼眶病变患者于治疗前行常规MRI平扫和DWI检查,其中眼眶良性病变45例,恶性病变33例,测量病变的ADC均值,进行校正t检验统计处理和分析,运用受试者工作特征曲线(ROC)评价ADC值的诊断价值。结果良性病变ADC值为(1.42±0.36)×10^(-3)mm^2/s,恶性病变ADC值为(0.70±0.19)×10^(-3)mm^2/s,恶性病变ADC值明显低于良性病变(t值为-11.43,P=0.000)。ADC值诊断眼眶良恶性病变的ROC曲线下面积为0.978,ADC值以1.03×10^(-3)mm^2/s为阈值时,以病理结果为对照,判断眼眶病变良恶性的敏感度为93.3%,特异度为100%,准确率为96.2%,与病理结果行一致性检验,Kappa值为0.922。结论眼眶良恶性病变具有不同的扩散特征,ADC值对于两者之间的鉴别诊断具有重要参考价值,可提高诊断正确率。Objective To observe the value of diffusion-weighted imaging （DWI）and apparent diffusion coefficient （ADC） value in the differential diagnoses of benign and malignant lesions of the orbit. Methods 78 patients with orbital lesions,including 45 benign lesions and 33 malignant lesions, underwent conventional MRI and DWI before therapy. ADC maps were reconstructed, and the ADC values of the orbital lesions were calculated. Diagnostic performance of ADC was compared using receiver operating characteristic （ROC） curves. Results The mean ADC values of benign lesions and ma- lignant lesions were（ 1.42±0.36 ）×10^-3 mmE/s and （0.70±0. 19 ）×10^-3 mm2/s, respectively. Malignant lesions had lower ADC values than benign lesions（t = - 11.43 ,P 〈0. 000）. The areas under the ROC curvves of ADC diagnosing benign and malignant lesions of the orbit was 0. 978. The optimal cutoff values of ADC for differentiating benign and malignant lesions of the orbit was 1.03 × 10^-3 mm2/s with sensitivity of 93.3% , specificity of 100% and accuracy of 96.2% and ADC had a high consistency compared with pathological results （Kappa values were 0. 922）. Conclusion Different features between benign and malignant lesions of the orbit are able to be identified with DWI ; it can be applied as a complementary tool in the detection of benign and malignant lesions of the orbit in order to increase the diagnostic accuracy.

关 键 词：眼眶病变 扩散加权成像 表观扩散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.7[医药卫生—诊断学]