DWI和动态对比增强MRI多参数鉴别腮腺Warthin瘤与多形性腺瘤  

Multiparameters of DWI and DCE-MRI in differentiation between parotid Warthin tumor and pleomorphic adenoma

作　　者：胡涛[1] 方学文[1] 刘琼[2] 邹玉坚[1] 姚兆友[3] 高云[1] 张坤林[1] HU Tao;FANG Xuewen;LIU Qiong;ZOU Yujian;YAO Zhaoyou;GAO Yun;ZHANG Kunlin(Department of Radiology,Dongguan People's Hospital of Guangdong Province,Dongguan 523000,China;Department of Sub-health,Dongguan People's Hospital of Guangdong Province,Dongguan 523000,China;Department of Oral and Maxillofacial Surgery,Dongguan People's Hospital of Guangdong Province,Dongguan 523000,China)

机构地区：[1]广东省东莞市人民医院放射科,东莞523000 [2]广东省东莞市人民医院亚健康管理中心,东莞523000 [3]广东省东莞市人民医院口腔颌面外科,东莞523000

出　　处：《磁共振成像》2021年第7期55-59,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的探讨弥散加权成像(diffusion weighted imaging,DWI)、动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)多参数鉴别诊断腮腺Warthin瘤与多形性腺瘤的价值。材料与方法回顾性分析病理学证实的24例腮腺Warthin瘤患者共32个病灶、24例多形性腺瘤的MRI及临床资料。评估患者一般资料、表观弥散系数值(apparent diffusion coefficient,ADC)、T1初始信号强度值(previous signal intensity,SI_(pre))、增强后最大信号强度值(maximum signal intensity,SI_(max))、增强期末信号强度值(signal intensity of the end of enhancement,SI_(end))、达峰时间(time to peak,TTP)、廓清率(wash-out ratio,WR)及时间信号强度曲线(time intensity curve,TIC)类型。用受试者工作特征(receiver operating characteristic,ROC)曲线分析组间有统计学差异的参数对Warthin瘤与多形性腺瘤的鉴别诊断效能。结果 Warthin瘤发病年龄与多形性腺瘤不同,前者大于后者(t=9.33,P<0.05);男女比例不同,前者以男性为主,后者以女性多见(P<0.05)。Warthin瘤ADC值[(0.634±0.201)×10^(-3)mm^(2)/s]显著低于多形性腺瘤[(1.084±0.453)×10^(-3)mm^(2)/s](t=-5.00,P<0.05)。两者SI_(pre)(t=4.01,P=0.0002)、WR (t=15.10,P<0.0001)、TTP (P<0.05)及TIC类型(P<0.05)差异有统计学意义。以ADC值=0.811×10^(-3)mm^(2)/s为阈值,鉴别Warthin瘤与多形性腺瘤的AUC为0.845 (P<0.05),敏感度为83.3%,特异度为90.63%;TIC类型区分二者的AUC为0.961 (P<0.05),敏感度为95.45%,特异度为100%;ADC值与TIC类型联合区分二者的AUC为0.984(P<0.05),敏感度为100%,特异度为96.88%。结论 DWI、DCE-MRI多参数及联合有助于鉴别Warthin瘤与多形性腺瘤。Objective:To investigate the value of multiparametric features including diffusion weighted imaging and dynamic contrast-enhanced MRI in differentiation between parotid Warthin tumor and pleomorphic adenoma(PA).Materials and Methods:Forty-eight patients were included in this study including 32 parotid Warthin tumors and 24 pleomorphic adenomas.Conventional and multiparametric MRI features were analyzed.Differences in conventional MRI features,ADCs,previous signal intensity(SIpre)、maximum signal intensity of enhancement(SImax)and signal intensity of the end of enhancement(SIend),wash-out ratio(WR),time to peak(TTP),and time-intensity curves(TICs)types between the two entities were determined byχ2 test and independent samples t-test.Receiver operating characteristic(ROC)curves of parameters being statistically different between groups were drawn for differential diagnosis of Warthin tumor and PA of parotid gland,and the corresponding diagnostic efficacy were analyzed.Results:The ages of Warthin tumors were significantly older than those of pleomorphic adenomas(t=9.33,P<0.05).The male to female ratios were significantly different between the two entities(P<0.05).The ADCs of Warthin tumors[(0.634±0.201)×10^(-3) mm^(2)/s]were significantly lower than those of pleomorphic adenomas[(1.084±0.453)×10^(-3) mm^(2)/s](t=-5.00,P<0.05).There were significant differences in SIpre(t=4.01,P=0.0002)、WR(t=15.10,P<0.0001)、TTP(P<0.05)and TIC types(P<0.05)between the two entities.Taking ADC=0.811×10^(-3) mm^(2)/s as threshold drawing ROC for differential diagnosis of Warthin tumor and PA of parotid gland,the area under the curve(AUC),sensitivity,specificity,were 0.845(P<0.05),83.3%,90.63%.Taking TIC types drawing ROC,the AUC,sensitivity,specificity,were 0.961(P<0.05),95.45%,100%.Taking ADCs combined with TIC types drawing ROC,the AUC,sensitivity,specificity,were 0.984(P<0.05),100%,96.88%.Conclusions:Multiparameters and combined parameters of DWI and DCE-MRI were helpful to differential diagnosis of Warthin tumor and pleomo

关 键 词：腮腺 腺淋巴瘤 腺瘤 多形性 诊断 鉴别 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R781.7[医药卫生—诊断学]