动态增强磁共振联合ADC值对上颌窦病变良恶性鉴别的诊断价值  

The Value of DCE-MRI Combined with ADC in the Differential Diagnosis of Benign and Malignant Maxillary Sinus Lesions

作　　者：刘希运[1] 王军[1] 张毅 张晓[2] 赵猛[2] LIU Xiyun;WANG Jun;ZHANG Yi;ZHANG Xiao;ZHAO Meng(Department of Equipment,Binzhou people's Hospital,Binzhou Shandong 256600,China;Department of Radiology,Binzhou people's Hospital,Binzhou Shandong 256600,China)

机构地区：[1]滨州市人民医院设备科,山东滨州256600 [2]滨州市人民医院放射科,山东滨州256600

出　　处：《中国医疗设备》2020年第9期97-102,119,共7页China Medical Devices

摘　　要：目的探讨动态增强磁共振成像(Dynamic Contrast Enhanced Magnetic Resonance Imaging,DCE-MRI)结合表观扩散系数(Apparent Diffusion Coefficient,ADC)对上颌窦病变良恶性鉴别的诊断意义。方法回顾性分析我院经手术病理证实的62例上颌窦病变患者临床资料,分为良性组(28例)及恶性组(34例),比较两组ADC、时间信号强度曲线(Time Intensity Curve,TIC)类型及DCE-MRI参数差异,采用受试者工作曲线(Receiver Operator Characteristics,ROC)比较各参数的诊断效能。结果良性病变28例,MRI示形态较规则,信号较均匀,边界较清,膨胀性生长为主。恶性病变34例,MRI示形态不规则、囊变坏死多见、边界欠清、侵袭性生长、周围组织结构受累。良、恶性病灶的平均ADC值有统计学差异(P<0.05)。良性病变TIC曲线以A型为主,恶性病变TIC为B或C型。良、恶性病变Tpeak、WR、K^trans有统计学差异(P<0.05)。K^trans灵敏度最高(84.52%),WR特异度最高(67.71%),K^trans和WR均有较高的阳性预测值、阴性预测值和准确度。结论MRI常规序列结合DWI与DCE-MRI对上颌窦病变的诊断价值较高,综合评估图像征象与量化指标,对提高诊断准确性有一定帮助。Objective To explore the diagnostic significance of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with apparent diffusion coefficient(ADC)in the differentiation of benign and malignant maxillary sinus diseases.Methods The clinical data of 62 patients with maxillary sinus disease confirmed by surgical pathology in our hospital were retrospectively analyzed and divided into benign group(28 cases)and malignant group(34 cases).The ADC,time intensity curve(TIC)type and DCE-MRI parameter differences in the two groups were compared,and the diagnostic efficiency of each parameter was compared by receiver operator characteristics(ROC).Results In 28 cases of benign lesions,MRI showed regular shape,uniform signal,clear boundary,and mainly expansive growth.In 34 cases of malignant lesions,MRI showed irregular shape,cystic necrosis,unclear boundary,invasive growth and involvement of surrounding tissue structure.The average ADC values,Tpeak,WR,and K^trans in benign and malignant lesions were significantly statistically different(P<0.05).Among them,the TIC curve of benign lesions was mainly A type,and the TIC of malignant lesions was B or C type.K^trans had the highest sensitivity(84.52%)and WR had the highest specificity(67.71%),and both K^trans and WR have higher positive predictive value,negative predictive value and accuracy.Conclusion The combination of conventional MRI sequence and DWI and DCE-MRI is of high value in the diagnosis of maxillary sinus diseases,and the comprehensive evaluation of image signs and quantitative indicators can help improve the accuracy of diagnosis.

关 键 词：表观扩散系数 动态增强 磁共振成像 上颌窦 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.8[医药卫生—诊断学]