常规及功能MRI在下颌下腺肿瘤良恶性鉴别中的应用价值  

Application value of conventional and functional MRI in differentiating benign from malignant submandibular gland tumors

作　　者：宋庆博 任继亮[1] 袁瑛[1] 陶晓峰[1] SONG Qingbo;REN Jiliang;YUAN Ying;TAO Xiaofeng(Department of Radiology,Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院放射科,上海200011

出　　处：《实用放射学杂志》2022年第9期1419-1422,共4页Journal of Practical Radiology

摘　　要：目的探讨常规及功能MRI特点在鉴别下颌下腺肿瘤良恶性中的应用价值.方法回顾性分析2015年1月至2021年7月经病理证实的下颌下腺肿瘤的动态增强MRI图像.评估病灶的常规及功能MRI特点,包括最大径、形态、边界、有无包膜、信号是否均匀、邻近结构侵犯及颈部淋巴结肿大情况、表观扩散系数(ADC)值及时间信号强度曲线(TIC)类型.使用χ2检验或Mann-WhitneyU检验比较良性组及恶性组的MRI特点.使用逻辑回归筛选出独立预测因子并建立联合模型.绘制受试者工作特征(ROC)曲线评估独立预测因子及其联合模型的诊断效能.结果共纳入67例,良性49例,恶性18例.病灶的边界不清、ADC值≤1.07×10^(-3) mm^(2)/s、TIC为Ⅱ型更倾向于恶性,三者及其联合模型曲线下面积(AUC)分别为0.734、0.813、0.696及0.856,敏感度分别为61.1%、77.8%、55.6%及88.9%,特异度分别为85.7%、89.8%、83.7%及81.6%.结论常规及功能MRI特点与下颌下腺肿瘤的良恶性相关,边界不清、ADC值≤1.07×10^(-3) mm^(2)/s、TIC为Ⅱ型相结合有助于鉴别下颌下腺肿瘤的良恶性,ADC值具有很高的特异性.Objective To explore the application value of conventional and functional MRI characteristics for differentiating between benign and malignant submandibular gland tumors.Methods A retrospective review of dynamic contrast-enhanced MRI findings was performed in patients with pathologically confirmed submandibular gland tumors between January 2015 and July 2021.Conventional and functional MRI characteristics were assessed,including dimension,shape,margin,capsule,adjacent tissue infiltration,cervical lymphadenopathy,apparent diffusion coefficient(ADC)and pattern of time-signal intensity curve(TIC).X2 test or Mann-Whitney U test was used to compare the differences of MRI characteristics between benign and malignant groups.Logistic regression was performed to determine the independent predicted factors and to build a combined model.Receiver operating characteristic(ROC)curves were generated to evaluate the diagnostic performance of independent predicted factors and com bined model.Results A total of 67 patients were included,consisting of 49 benign and 18 malignant tumors.The lesions with il-defined margin,ADC≤1.07X 10^(-3) mm^(2)/s,and plateau TIC pattern were more likely to be malignant than those without these findings.These three characteristics and the combined model achieved area under the curve(AUC)of 0.734,0.813,0.696,and 0.856,sensitivities of 61.1%,77.8%,55.6%,,and 88.9%,specificities of 85.7%,89.8%,83.7%,and 81.6%,respectively.Conclusion Conventional and functional MRI charac-teristics are associated with benignity and malignancy in submandibular gland.There is added value with ll-defined margin,ADC≤1.07X10^(-3) mm^(2)/s and plateau TIC pattern in characterizing submandibular gland tumors,the ADC value has high specificity.

关 键 词：下颌下腺肿瘤 磁共振成像 表观扩散系数 时间信号强度曲线 

分 类 号：R739.91[医药卫生—肿瘤] R445.2[医药卫生—临床医学]