EP-DWI与TSE-DWI两种序列诊断中耳胆脂瘤效能的比较  

Comparison of echo-planar and turbo spin-echo diffusion-weighted imaging sequence in the diagnosis of middle ear cholesteatoma

作　　者：樊晓雪[1] 丁长伟[1] 刘兆玉[1] FAN Xiaoxue;DING Changwei;LIU Zhaoyu(Department of Radiology,Shengjing Hospital of China Medical University,Shenyang 110000,China)

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110000

出　　处：《磁共振成像》2022年第6期5-9,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：辽宁省自然科学基金(编号:20170541045)。

摘　　要：目的比较平面回波弥散加权成像(echo planar diffusion weighted imaging,EP-DWI)与快速自旋回波弥散加权成像(turbo spin-echo diffusion weighted imaging,TSE-DWI)两种序列对中耳胆脂瘤的诊断效能。材料与方法本研究回顾性分析临床初步怀疑中耳胆脂瘤患者病例63例。所有患者均采用Philips Ingenia 3.0 T超导型磁共振扫描仪及32通道头线圈行EP-DWI、TSE-DWI扫描,并随后进行手术治疗。以病理结果为金标准,将影像诊断与术后病理进行对比,并计算EP-DWI、TSE-DWI序列诊断疑似中耳胆脂瘤患者的曲线下面积(area under the curve,AUC)、敏感度、特异度、阳性预测值、阴性预测值。结果63例疑似中耳胆脂瘤患者中,最终病理确诊胆脂瘤47例,非胆脂瘤16例。TSW-DWI较EP-DWI诊断中耳胆脂瘤AUC值显著增高(TSE-DWI vs.EP-DWI:0.895 vs.0.644,P<0.05)。TSE-DWI诊断胆脂瘤的敏感度(91.49%)、特异度(87.50%)较EP-DWI(敏感度、特异度分别为78.72%、50.00%)高。结论TSE-DWI较EP-DWI能显著提高诊断准确性,减少误诊率。TSE-DWI在中耳胆脂瘤诊断中能够提高诊断可信度,对临床诊断有较高的应用价值。Objective:To compare the diagnostic performance of echo planar diffusion weighted imaging(EP-DWI)and turbo spin-echo diffusion weighted imaging(TSE-DWI)for middle ear cholesteatoma.Materials and Methods:This study prospectively enrolled 63patients with preliminary clinical suspicion of middle ear cholesteatoma;all patients underwent EP-DWI and TSE-DWI scans using a Philips Ingenia 3.0 T superconducting magnetic resonance scanner and a 32-channel head coil and subsequent surgical treatment.Using pathological results as the gold standard,the imaging diagnosis and postoperative pathology were compared,and area under the curve(AUC),sensitivity,specificity,positive predictive value,and negative predictive value of EP-DWI and TSE-DWI sequences in the diagnosis of suspected cholesteatoma were calculated.Results:Among the 63 patients with suspected middle ear cholesteatoma,47 were pathologically diagnosed as cholesteatoma and 16 were non-cholesteatoma.The accuracy of TSW-DWI in the diagnosis of middle ear cholesteatoma was significantly higher than that of EP-DWI(TSE-DWI vs.EP-DWI:0.895 vs.0.644,P<0.05).The sensitivity(91.49%)and specificity(87.50%)of TSE-DWI in diagnosing cholesteatoma were higher than those of the EP-DWI(sensitivity:78.72%,specificity:50.00%)sequence.Conclusions:Compared with EP-DWI,TSE-DWI can significantly improve diagnostic accuracy and reduce the misdiagnosis rate.TSE-DWI can improve the diagnostic confidence in middle ear cholesteatoma and has a high application value for clinical diagnosis.

关 键 词：中耳 胆脂瘤 弥散加权成像 平面回波 快速自旋回波 磁共振成像 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R764.2[医药卫生—诊断学]