拉伸指数模型不相干运动成像定量参数在鼻咽癌与鼻咽炎性增生疾病鉴别诊断的价值  

Value of quantitative parameters based on stretch exponential diffusion model of the diffusion weighted image in the differential diagnosis of nasopharyngeal carcinoma and nasopharyngeal hyperplasia disease

作　　者：卢贤忠 孟志华[1] 孙俊旗[1] 黄钟情[1] 万志方[1] LU Xianzhong MENG Zhihua SUN Junqi HUANG Zhongqing WAN Zhifang(Department of Radiology, Affiliated Yubei Peo- ple＇s Hospital,Medical College of Shantou University,Shaoguan 512026, China Medical College of Shantou University)

机构地区：[1]汕头大学医学院附属粤北人民医院影像科,韶关512026 [2]汕头大学医学院

出　　处：《山西医科大学学报》2017年第6期627-631,共5页Journal of Shanxi Medical University

摘　　要：目的探讨拉伸指数模型不相干运动成像(IVIM)定量参数在鼻咽癌与鼻咽炎症鉴别诊断的价值。方法选择2015-10~2016-06期间临床怀疑鼻咽癌患者80例。患者均行MRI检查,不相干运动弥散加权成像(IVIM DWI)扫描采用13个b值(0,10,20,30,50,80,100,150,200,300,400,600,800 s/mm^2)。患者MR检查后均在1周内行鼻咽部活检;根据不同病理结果分为2组:鼻咽癌(NPC)组和鼻咽炎症(NPH)组。通过Function tool AW4.6后处理软件,勾画病灶感兴趣区(region of interest,ROI),测量DDC值和Alpha值。使用SPSS19.0统计软件,应用独立样本t检验法及两个独立样本非参数检验法分别比较两组间DDC值和α值有无统计学差异。然后分别绘制两组DDC值和α值的ROC曲线,计算曲线下面积,确定阈值及诊断效能。结果鼻咽癌组35例,鼻咽炎症组30例入组。鼻咽癌组和鼻咽炎症组DDC值分别为(0.88±0.29)×10^(-3)mm/s和(1.0±0.5)×10^(-3)mm/s,两者差异有统计学意义(t=2.380,P<0.05);两组Alpha值分别为0.75±0.08和0.79±0.1,差异无统计学意义(U=1.585,P>0.05)。DDC值ROC曲线显示DDC值曲线下面积为0.732,最佳诊断阈值为1.02×10^(-3)mm/s,敏感度和特异度分别为0.533和0.867。结论拉伸指数模型不相干运动成像定量化诊断鼻咽癌与鼻咽炎症疾病,体现肿瘤异质性信息,表明DDC值是鼻咽癌的独立预测因素,在肿瘤定性评估中具有良好的应用前景。Objective To explore the value of the quantitative parameters based on stretch exponential diffusion model of the diffusion weighted image in the differential diagnosis of nasopharyngeal carcinoma and nasopharyngeal hyperplasia. Methods From October 2015 to June 2016,80 consecutive patients with suspected NPC were examined on a 1.5 T MR scanner. IVIM DWI was performed using a single-shot echo-planar sequence with different b-values （0,10,20,30,50,80,100,150,200,300,400,600,800 s/mm2 ）. MR ima- ging was compared with endoscopy and biopsy for the detection of NPC. The subsequent nasopharyngeal biopsy was performed in 1 week after MRI examination. The subjects were divided into 2 groups according to the pathological results ： nasopharyngeal carcinoma group and nasopharyngeal hyperplasia group. Through the AW4. 6 Functiontool post-processing software, the ROI was outlined and DDC and （x values were measured. Using the SPSS 19. 0 statistical software,independent samples t test and two independent samples nonparametric test were used to compare the DDC value and the cL value between the two groups. The ROC curve was drawn to calculate the area under the curve and determine the threshold value and diagnostic efficiency. Results IVIM DWI was successful in 35 patients with naso- pharyngeal carcinoma and 30 patients with nasopharyngeal hyperplasia. DDC value was significantly lower in nasopharyngeal carcinoma group than in nasopharyngeal hyperplasia group [ （0. 88 ± 0. 29 ） × 10^-3 mm/s vs （ 1.0 ± 0. 5 ） × 10^ -3 mm/s, t = 2. 380, P 〈 0. 05 ]. However, ct value was 0.75 ± 0. 08 in nasopharyngeal carcinoma group and 0. 79 ＋ 0. 1 in nasopharyngeal hyperplasia group （ U = 1. 585 ,P 〉 0. 05）. DDC ROC curves showed that the area under the DDC curve was 0. 732, the best diagnostic threshold was 1.02 × 10^-3 mm/s,and the sensitivity and specificity were 0. 533 and 0. 867. Conclusion The stretched model of incoherent motion imaging may quantitatively diagnose nasopharyngeal hyperplasia and nasophary

关 键 词：拉伸指数模型 鼻咽癌 鼻咽炎性增生性疾病 鉴别诊断 

分 类 号：R739.6[医药卫生—肿瘤]