高分辨率DWI表观扩散系数直方图鉴别腮腺常见肿瘤  

Application of high resolution DWI apparent diffusion coefficient histogram analysis in the differentiation diagnosis of common parotid gland tumors

作　　者：宋承汝[1] 程敬亮[1] 张勇[1] 张赞霞 吕青青[1] 许珂[1] SONG Cheng-nu;CHENG Jing-liang;ZHANG Yong(Department of Magnetic Resonance,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院磁共振科

出　　处：《放射学实践》2019年第7期749-754,共6页Radiologic Practice

摘　　要：目的:探讨基于MRI高分辨率DWI表观扩散系数(ADC)的直方图分析对腮腺常见三类肿瘤(多形性腺瘤、Warthin瘤、腮腺恶性肿瘤)的鉴别诊断价值。方法:回顾性分析本院行MR检查并经病理证实的69例腮腺常见肿瘤,其中多形性腺瘤36例,Warthin瘤14例,腮腺恶性肿瘤19例。利用Mazda软件于肿瘤最大层面ADC图像上勾画瘤体兴趣区,进行直方图分析并提取出12个参数(面积、最小值、最大值、均值、变异度、偏度、峰度、第1百分位数、第10百分位数、第50百分位数、第90百分位数、第99百分位数)。对三组肿瘤的各直方图参数进行统计学分析,找出具有统计学差异的参数特征,并利用ROC曲线分析各参数的鉴别诊断效能。结果:通过直方图分析得到的12个参数中,有9个参数在三组间的差异具有统计学意义(P均<0.05)。在多形性腺瘤与Warthin瘤两组间,有8个参数的差异均具有统计学意义(P均<0.05),其中第10百分位数和均值诊断效能较高,曲线下面积(AUC)分别为0.911、0.909。在多形性腺瘤与恶性肿瘤两组间,亦有8个参数差异具有统计学意义(P均<0.05),其中第10百分位数和第50百分位数诊断效能较高,AUC分别为0.841、0.832。但在Warthin瘤与恶性肿瘤两组间,仅均值差异具有统计学意义(P<0.05)。结论:基于ADC的直方图分析有助于腮腺常见肿瘤的鉴别诊断,可提供更多量化信息特征。Objective: The purpose of this study was to evaluate whether histogram-based analysis of MRI high resolution diffusion weighted imaging apparent diffusion coefficient (ADC) could help in the differentiation of common parotid gland tumors (i.e.,pleomorphic adenoma,Warthin tumor,malignant parotid gland tumor). Methods: The MR images of 36 patients with a biopsy- or surgery-proven pleomorphic adenomas,14 with Warthin tumors and 19 with malignant parotid gland tumors were retrospectively analyzed.Histogram-based analysis was performed with the software MaZda (version 4.6),with ROI measures of ADC maps.Parameters such as area,MinNorm,MaxNorm,mean,variance,skewness,kurtosis,Perc.01%,Perc.10%,Perc.50%,Perc.90%,Perc.99% derived from histogram were calculated.Statistical analysis of the three groups were performed to find out the statistical significance of each histogram parameter.The differential efficiency of each parameter were determined using a receiver operating characteristic curve (ROC) analysis. Results: Nine out of 12 parameters of three groups were statistically significant ( P <0.05).Between the pleomorphic adenomas and Warthin tumors,8 parameters (MinNorm,MaxNorm,mean,skewness,Perc.10%,Perc.50%,Perc.90%,Perc.99%) were of statistical significance.Perc.10% and mean revealed high diagnostic efficiency with the areas under the ROC curve (AUC) of 0.911,0.909,respectively.Also between the pleomorphic adenomas and malignant parotid gland tumors,8 parameters were of statistical significance.Perc.10% and Perc.50% revealed high diagnostic efficiency with AUC of 0.841,0.832,respectively.While as between the Warthin tumors and malignant parotid gland tumors,only one parameter (mean) was statistically significant. Conclusion: Histogram-based analysis of ADC maps are effective in the differentiations diagnosis of common parotid gland tumors.

关 键 词：磁共振成像 扩散加权成像 表观扩散系数 腮腺肿瘤 直方图分析 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.87[医药卫生—诊断学]