最小ADC值在腮腺肿块良、恶性鉴别诊断中的价值  

The value of ADCmin in the differential diagnosis between benign and malignant parotid mass

作　　者：詹浩辉[1] 李新瑜[2] 杨静[2] ZHAN Haohui;LI Xinyu;YANG Jing(MR Room,Second Affiliated Hospital of Henan Science and Technology University,Luoyang 471000,P.R.China;MR Room,First Affiliated Hospital of Henan Science and Technology University,Luoyang 471003,P.R.China)

机构地区：[1]河南科技大学第二附属医院MR室,河南洛阳471000 [2]河南科技大学第一附属医院影像中心MR室,河南洛阳471003

出　　处：《医学影像学杂志》2020年第9期1574-1577,共4页Journal of Medical Imaging

摘　　要：目的探讨最小表观扩散系数(ADC)值在鉴别诊断腮腺良、恶性肿块的价值。方法回顾性分析经手术病理证实的100例(148个病灶)腮腺良性肿块和35例(41个病灶)恶性肿瘤的MRI资料,测量并比较腮腺良、恶性肿块的最小ADC值。结果在DWI序列扫描中,腮腺良性和恶性肿块均呈高信号,恶性肿瘤最小ADC值为(1.08±0.27)×10^-3 mm^2/s,低于混合瘤(1.38±0.29)×10^-3 mm^2/s、高于良性淋巴源性肿块(0.72±0.28)×10^-3 mm^2/s,两者间差异均有统计学意义(P<0.01)。经ROC曲线分析,ADCmin阈值为1.17×10^-3 mm^2/s时,区分腮腺恶性肿瘤和混合瘤的诊断灵敏度、特异度和曲线下面积分别为74.2%、75.6%和0.825;ADCmin阈值为0.94×10^-3 mm^2/s时,区分腮腺恶性肿瘤和良性淋巴源性肿块诊断的敏感度、特异度和曲线下面积分别为85.4%、81.5%和0.959%。结论最小ADC值对腮腺良、恶性肿块具有鉴别诊断价值,ADCmin值在0.94×10^-3 mm^2/s^1.17×10^-3 mm^2/s区间对恶性肿瘤的诊断敏感度、特异度较高。Objective To explore the value of the minimum ADC value in the differential diagnosis between benign and malignant parotid mass.Methods MRI data of 100 patients(148 lesions)with parotid benign mass and 35 patients(41 lesions)with malignant were retrospectively,the minimum ADC value of lesions was measured and compared.Results All benign and malignant parotid mases showed hyperintensity signal in DWI.The minimum ADC value of malignant tumors(1.08±0.27)×10^-3 mm^2/s was lower than mixed tumors(1.38±0.29)×10^-3 mm^2/s,and higher than other benign lymph derived tumors(0.72±0.28)×10^-3 mm^2/s,the difference was statistically significant(P<0.05).By ROC curve analysis,using a threshold ADCmin value of 1.17×10^-3 mm^2/s for differentiating parotid malignant mass from mixed tumors,a sensitivity of 74.2%and specificity of 75.6%were obtained,the area under the ROC curve was 0.825;using a threshold ADCmin value of 0.94×10^-3 mm^2/s for differentiating parotid malignant mass from lymph derived tumors,a sensitivity of 85.4%and specificity of 81.5%were obtained,the area under the ROC curve was 0.959.Conclusion The minimum ADC value is helpful for the differential diagnosis between benign and malignant parotid mass.ADCmin value in the range of 0.94×10^-3 mm^2/s^1.17×10^-3 mm^2/s has sensitivity and specificity in the diagnosis of malignant mass.

关 键 词：腮腺 肿块 良性 恶性 磁共振成像 

分 类 号：R739.87[医药卫生—肿瘤] R445.2[医药卫生—临床医学]