多参数MRI鉴别腮腺单发Warthin瘤与多形性腺瘤的价值  

Value of multiparametric MRI in differentiation between solitary parotid Warthin tumor and pleomorphic adenoma

作　　者：姜虹[1] 陈青华[1] 王永哲[1] 鲜军舫[1] 刘中林[1] 张红[2] 刘芳[3] JIANG Hong;CHEN Qinghua;WANG Yongzhe;XIAN Junfang;LIU Zhonglin;ZHANG Hong;LIU Fang(Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China;Department of Pathology,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China;Department of Otolaryngology,Beijing Hospital,National Center of Gerontology,Beijing,100730,China)

机构地区：[1]首都医科大学附属北京同仁医院放射科,北京100730 [2]首都医科大学附属北京同仁医院病理科,北京100730 [3]北京医院耳鼻咽喉科,国家老年医学中心,北京100730

出　　处：《中国耳鼻咽喉头颈外科》2020年第3期115-118,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：北京市高层次卫生人才学科带头人(2014-2-005)。

摘　　要：目的探讨多参数MRI鉴别腮腺单发Warthin瘤与多形性腺瘤的价值。方法回顾性分析病理学证实的26例腮腺单发Warthin瘤、35例多形性腺瘤的MRI资料。评估常规MRI特征、ADC值、达峰时间(Tpeak)、流出率(WR)及时间信号强度曲线(TIC)类型。结果Warthin瘤ADC值[(0.89±0.22)×10^-3 mm^2/s]显著低于多形性腺瘤[(1.54±0.34)×10^-3 mm^2/s](t=-8.60,P<0.05)。两者Tpeak(t=-14.74)、WR(t=8.75)及TIC类型(χ2=61.00)的差异有统计学意义(P<0.05)。以ADC值=1.24×10^-3 mm^2/s作为阈值,鉴别Warthin瘤与多形性腺瘤的敏感度为82.86%(29/35),特异度为100%(26/26),准确率为90.16%(55/61)。将ADC值与TIC类型进行线性拟合并绘制ROC,曲线下面积为0.996,敏感度为94.29%(33/35),特异度为100%(26/26),准确率为96.72%(59/61)。结论多参数MRI可提高鉴别腮腺单发Warthin瘤与多形性腺瘤的效能。OBJECTIVE To identify the value of m ultiparam etric MR im aging features including diffusion weighted(DW)and dynamic contrast-enhanced(DCE)MR imaging features in differentiation between solitary parotid pleomorphic adenoma and Warthin tumor.METHODS Sixty-one patients were included in this study including 35 parotid pleomorphic adenomas and 26 Warthin tumors.Multiparametric MRI including DCEand the DW-MRI were analyzed.All cases were solitary tumors with diameter>1 cm and were confirmed by histology.Differences in conventional MRI features,ADCs,time to peak enhancement(Tpeak),wash-out ratio(WR)and time-intensity curves(TICs)types between the two entities were determined b yχ2 test and independent samples t-test,and receiver operating characteristic curve(ROC)was drawn.RESULTS The ADCs of Warthin tumors[(0.89±0.22)×10^-3 mm^2/s]were significantly lower than those of pleomorphic adenomas[(l.54±±0.34)×10^-3 mm^2/s](f=-8.60,P<0.05).There were significant differences in Tpeak(f=-14.74),WR(r=8.75)and TIC ty pes(χ2=61.00)between the two entities(P<0.05).Taking ADC=1.24×10^-3 mm^2/s as threshold drawing ROC,the sensitivity,specificity,accuracy were 82.86%(29/35),100%(26/26),90.16%(55/61).Taking ADCs combined with TIC types drawing ROC,the AUC was 0.996,the values were 94.29%(33/35),100%(26/26),96.72%(59/61).CONCLUSION A multiparametric approach using conventional MR imaging had the potential to improve the differentiation between solitary parotid Warthin tumor and pleomorphic adenoma.

关 键 词：腮腺肿瘤 腺瘤 多形性 诊断 鉴别 多参数磁共振成像 

分 类 号：R739.8[医药卫生—肿瘤] R445.2[医药卫生—临床医学]