分段读出扩散加权成像在腮腺肿瘤鉴别诊断中的价值  

The value of RESOLVE-DWI in differential diagnosis of parotid gland tumors

作　　者：姜家锁 苏国义[1] 胡昊[1] 朱榴宁 卜寿山[2] 许晓泉[1] 吴飞云[1] JIANG Jiasuo;SU Guoyi;HU Hao;ZHU Liuning;BU Shoushan;XU Xiaoquan;WU Feiyun(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Stomatology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029 [2]南京医科大学第一附属医院口腔科,江苏南京210029

出　　处：《实用放射学杂志》2019年第12期1914-1917,共4页Journal of Practical Radiology

摘　　要：目的探讨分段读出扩散加权成像(RESOLVE-DWI)及ADC在腮腺肿瘤鉴别诊断中的价值。方法回顾性分析经手术病理证实的腮腺肿瘤87例患者的临床及影像学资料。避开肿瘤囊变、坏死及出血区,在肿瘤最大层面的ADC图上,手动勾画3个圆形ROI,测量平均ADC值(ADCm)。采用独立样本t检验比较腮腺良恶性肿瘤组间ADCm的差异。采用单因素方差分析比较腮腺多形性腺瘤、腺淋巴瘤和恶性肿瘤3组间ADCm的差异。采用ROC曲线分析ADCm对腮腺肿瘤的鉴别诊断价值。结果腮腺良性及恶性肿瘤组间ADCm差异无统计学意义(P=0.071)。腮腺多形性腺瘤、腺淋巴瘤及恶性肿瘤3组组间ADCm差异有统计学意义(P<0.001)。两两比较均有统计学差异(多形性腺瘤vs腺淋巴瘤,P<0.001;多形性腺瘤vs恶性肿瘤,P<0.001;腺淋巴瘤vs恶性肿瘤,P=0.030)。ADCm在3组肿瘤两两鉴别中的AUC分别为:多形性腺瘤vs腺淋巴瘤,AUC>0.999;多形性腺瘤vs恶性肿瘤,AUC=0.822;腺淋巴瘤vs恶性肿瘤,AUC=0.807。结论腮腺常见肿瘤中腺淋巴瘤ADC值最低,随后依次是恶性肿瘤和多形性腺瘤。RESOLVE-DWI可以准确评估腮腺肿瘤ADC值,辅助肿瘤鉴别诊断。Objective To investigate the value of readout segmentation of long variable echo-trains diffusion weighted imaging(RESOLVE-DWI)and ADC in differential diagnosis of parotid gland tumors.Methods Clinical and imaging data of 87 patients with parotid gland tumors confirmed by surgery and pathology were analyzed retrospectively.Three circular ROI were manually drawn on the ADC images,while avoiding cystic,necrotic and bleeding areas.Mean ADC values(ADCm)were achieved.Student t test was used to compare ADCm between benign and malignant groups.Owe-Way ANOVA analysis was used to compare the difference of ADCm among three groups(pleomorphic adenoma,Warthin's tumor and malignant tumor).ROC curve analysis was used to assess the value of ADCm in differential diagnosis of parotid gland tumors.Results There was no significant difference in ADCm between benign and malignant groups(P=0.071).The ADCm of parotid pleomorphic adenoma,Warthin's tumor and malignant tumor was significantly different(P<0.001).There were significant differences between each two groups(pleomorphic adenoma vs Warthin's tumor,P<0.001;pleomorphic adenoma vs malignant tumor,P<0.001;Warthin's tumor vs malignant tumor,P=0.030,respectively).The AUC of ADCm was as following:(pleomorphic adenoma vs Warthin's tumor,AUC>O.999;pleomorphic adenoma vs malignant tumor,AUC=0.822;Warthin's tumor vs malignant tumor,AUC=0.807).Conclusion Among the common parotid gland tumors,Warthin's tumor shows the lowest ADC,followed by malignant tumors and pleomorphic tumor.RESOLVE-DWI can accurately assess the ADC of parotid gland tumors,and assist tumor differential diagnosis.

关 键 词：腮腺肿瘤 扩散加权成像 表观扩散系数 

分 类 号：R739.91[医药卫生—肿瘤] R445.2[医药卫生—临床医学]