磁共振T_(1)序列对腮腺腺淋巴瘤与恶性肿瘤鉴别诊断价值的研究  

Differential Diagnosis of Warthin Tumor and Malignant Tumor Based on Magnetic Resonance T_(1)Sequence

作　　者：刘硕[1] 史灵雪 于保婷 郭昊 杨鸿声 管玉瑶 郑雪微 李佟[1] 丁军[1] LIU Shuo;SHI Lingxue;YU Baoting(Department of Radiology,Jilin University China-Japan Union Hospital,Changchun,Jilin Province 130033,P.R.China)

机构地区：[1]吉林大学中日联谊医院放射科,长春130033 [2]吉林省人民医院放射线科,长春130000 [3]长春市人民医院放射线科,130051

出　　处：《临床放射学杂志》2023年第5期739-742,共4页Journal of Clinical Radiology

基　　金：吉林省教育厅科研基金资助课题(编号:JJKH20201057KJ)。

摘　　要：目的探讨磁共振T_(1)WI最大信号强度值与咬肌、脊髓信号平均值的比值(T_(1)-max-SIR)对腺淋巴瘤与恶性肿瘤的鉴别诊断价值。方法选取经病理证实为腮腺肿瘤的148例患者,其中腺淋巴瘤90例,恶性肿瘤58例,患者术前行常规MRI扫描,测量肿瘤T_(1)WI最大信号强度值与同层面咬肌及脊髓信号强度平均值,计算相应T_(1)-max-SIR,应用受试者工作特征(ROC)曲线评估二者对腮腺腺淋巴瘤与恶性肿瘤的诊断价值,二者之间的ROC曲线比较采用DeLong检验。结果与腮腺腺淋巴瘤相比,腮腺恶性肿瘤T_(1)-max-SIR咬肌及T_(1)-max-SIR脊髓均降低(P<0.05),ROC显示T_(1)-max-SIR咬肌及T_(1)-max-SIR脊髓曲线下面积分别约为0.925、0.875,最佳临界值分别约1.600、1.278。ROC曲线DeLong检验结果表明,P值>0.05,无显著统计学意义。结论T_(1)-max-SIR咬肌与T_(1)-max-SIR脊髓能够为腮腺腺淋巴瘤及恶性肿瘤的诊断及鉴别诊断提供参考依据,且操作简便,便于广泛应用,具有重要的临床指导意义。Objective To investigate the value of the ratio of the maximum signal intensity of magnetic resonance T_(1)WI to the average signal intensity of masseter muscle and spinal cord(T_(1)-Max-SIR)in the differential diagnosis of Warthin tumor and malignant tumor.Methods A total of 148 cases of parotid gland tumors confirmed by pathology were selected,including 90 cases of Warthin tumor and 58 cases of malignant tumors.The patients underwent routine MR scanning before operation.The maximum signal intensity of tumor T_(1)WI and the average signal intensity of masseter muscle and spinal cord on the same plane were measured,and the corresponding T_(1)Max Sir was calculated.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of Warthin tumor and malignant tumor.The ROC curve between them was compared by DeLong test.Results compared with Warthin tumor,both the T_(1)-max-SIR masseter and the T_(1)-max-SIR spinal cord in malignancies were reduced(P<0.05).The area under the curve of T_(1)Max Sir masseter muscle and T_(1)Max Sir spinal cord was about 0.925 and 0.875 respectively,and the optimal critical value was about 1.600 and 1.278 respectively.The results of DeLong test of ROC curve showed that the p value was greater than 0.05,which was not statistically significant.Conclusion T_(1)Max Sir masseter muscle and T_(1)Max Sir spinal cord can provide reference basis for the diagnosis and differential diagnosis of Warthin tumor and malignant tumor.It is easy to operate,to be widely used,and has important clinical guiding significance.

关 键 词：腺淋巴瘤 腮腺恶性肿瘤 咬肌 脊髓 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.8[医药卫生—诊断学]