DCE-MRI、DWI参数联合混合唾液肿瘤标志物鉴别腮腺肿瘤的临床价值  

Value of dynamic contrast-enhanced MRI and diffusion weighted image parameters combined with mixed salivary tumor markers for identification of parotid tumors

作　　者：史玲珊[1] SHI Ling-shan(Radiology Department,Liyang People's Hospital,Liyang 213300,Jiangsu Province,China)

机构地区：[1]溧阳市人民医院放射科,江苏溧阳213300

出　　处：《医疗卫生装备》2022年第12期48-54,共7页Chinese Medical Equipment Journal

摘　　要：目的:评价MRI动态增强扫描(dynamic contrast-enhanced MRI,DCE-MRI)及弥散加权成像(diffusion weighted image,DWI)的半定量参数和定量参数联合混合唾液肿瘤标志物鉴别腮腺肿瘤的临床价值。方法:回顾性选取2016年4月至2021年2月经手术病理证实的腮腺肿瘤患者115例(115个肿块),均行DCE-MRI、DWI检查及混合唾液肿瘤标志物检测,比较各类型肿瘤的时间-信号强度曲线(time-intensity curve,TIC)类型、定量参数[表观扩散系数(apparent diffusion coefficient,ADC)、容量转运常数(K_(trans))、速率常数(K_(ep))、血管外细胞外间隙容积比(V_(e))]、混合唾液肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、乳铁蛋白(LF)、转铁蛋白(TF)]水平。采用SPSS 23.0软件进行统计学分析,并利用ROC曲线分析DCE-MRI与DWI的定量参数、半定量参数联合混合唾液肿瘤标志物诊断恶性腮腺肿瘤的效能。结果:良性肿瘤中多形性腺瘤多为A型TIC(87.50%),腺淋巴瘤多为B型TIC(70.37%),恶性肿瘤多为C型TIC(90.48%);恶性肿瘤的ADC值较多形性腺瘤、其他良性肿瘤低(P<0.05),K_(ep)低于腺淋巴瘤、其他良性肿瘤(P<0.05),V_(e)低于多形性腺瘤、其他良性肿瘤(P<0.05),高于腺淋巴瘤(P<0.05),不同类型肿瘤的K_(trans)比较差异无统计学意义(P>0.05);恶性肿瘤患者的CEA、CA125、LF、TF水平高于良性肿瘤患者(P<0.05);DCE-MRI、DWI与混合唾液肿瘤标志物联合诊断恶性腮腺肿瘤的敏感度、特异度、准确率分别为90.48%、90.43%、90.43%,AUC值为0.905。结论:DCE-MRI与DWI的半定量及定量参数联合混合唾液肿瘤标志物在鉴别腮腺肿瘤方面具有较好的效能,值得在临床推广应用。Objective To evaluate the clinical value of semi-quantitative and quantitative parameters of dynamic contrastenhanced MRI (DCE-MRI) and diffusion weighted imaging (DWI) combined with mixed salivary tumor markers for identifying parotid tumors.Methods Totally 115 parotid tumor patients (115 masses) confirmed by surgery and pathology were selected between April 2016 and February 2021,who all underwent the examinations by DCE-MRI,DWI and mixed salivary tumor markers.All types of tumors were compared on the type of time-intensity curve (TIC),quantitative parameters such as apparent diffusion coefficient (ADC),volume transfer constant (K_(trans)),rate constant (K_(ep)) and extravascular extracellular space volume ratio (V_(e)) and the levels of mixed salivary tumor markers including carcinoembryonic antigen (CEA),glycoantigen 125(CA125),lactoferrin (LF) and transferrin (TF).SPSS 23.0 software was used for statistical analysis,and the efficacy of semiquantitative and quantitative parameters of DCE-MRI and DWI combined with mixed salivary tumor markers for identifying malignant parotid tumors was analyzed with ROC curve.Results In benign tumors pleomorphic adenomas (87.50%) had type A TIC and adenolymphomas had type B TIC (70.37%) mostly,and malignant tumors had type C TIC (90.48%) mostly;malignant tumors had their ADC values lower than those of pleomorphic adenoma and other benign tumors (P<0.05),K_(ep) values lower than those of adenolymphoma and other benign tumors (P<0.05) and Vevalues lower than those of pleomorphic adenoma and other benign tumors (P<0.05) while higher than those of adenolymphoma (P<0.05),and the differences in Ktransbetween different types of tumors were not statistically significant (P>0.05);the levels of CEA,CA125,LF and TF were higher in patients with malignant tumors than in patients with benign tumors (P<0.05);the sensitivity,specificity and accuracy of combined DCE-MRI,DWI and mixed salivary tumor markers for diagnosing malignant parotid tumors were 90.48%,90.43%and 90.43%,respectively,with

关 键 词：DCE-MRI DWI 混合唾液肿瘤标志物 腮腺肿瘤 定量参数 半定量参数 

分 类 号：R318[医药卫生—生物医学工程] R445.2[医药卫生—基础医学]