扩散加权成像在鉴别低、高风险胸腺瘤和胸腺囊肿中的应用  

Diffusion Weighted Imaging in the Identification of Low-Risk Thymoma,High-Risk Thymoma and Thymic Cyst

作　　者：杨晶[1,2] 高艳 李琼阁[1,2] 单艺 赵澄 卢洁[1,2] YANG Jing;GAO Yan;LI Qiongge;SHAN Yi;ZHAO Cheng;LU Jie(Department of Radiology and Nuclear Medicine,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院放射与核医学科,北京100053 [2]磁共振成像脑信息学北京市重点实验室,北京100053

出　　处：《中国医学影像学杂志》2023年第7期727-731,742,共6页Chinese Journal of Medical Imaging

基　　金：北京市医院管理局“登峰”计划专项经费资助(DFL20180802)。

摘　　要：目的探讨3个b值的胸部扩散加权成像(DWI)的表观扩散系数(ADC)b0-900、ADCb150-900值区分低、高风险胸腺瘤和胸腺囊肿的能力。资料与方法参考术后病理结果,前瞻性纳入2017年1月—2020年1月首都医科大学宣武医院26例低风险胸腺瘤、8例高风险胸腺瘤和8例胸腺囊肿进行MRI和DWI。测量3组所有占位在ADCb0-900和ADCb150-900图像上的ADC值,使用受试者工作特征曲线分析ADCb0-900、ADCb150-900值鉴别低、高风险胸腺瘤以及低风险胸腺瘤和胸腺囊肿的效能。结果低、高风险胸腺瘤和胸腺囊肿3组占位的ADCb0-900值分别为(2.04±0.50)×10^(-3)mm^(2)/s、(1.21±0.50)×10^(-3)mm^(2)/s和(3.52±0.54)×10^(-3)mm^(2)/s,ADCb150-900值分别为(1.59±0.49)×10^(-3)mm^(2)/s、(0.82±0.15)×10^(-3) mm^(2)/s和(2.73±0.24)×10^(-3)mm^(2)/s,差异有统计学意义(P均<0.001)。低、高风险胸腺瘤的ADC b0-900和ADCb150-900的曲线下面积、Cutoff值、敏感度、特异度和准确度分别为0.885、1.35×10^(-3)mm^(2)/s、96.20%、75.00%、71.20%和0.964、1.06×10^(-3)mm^(2)/s、84.60%、100.00%、84.60%;低风险胸腺瘤和胸腺囊肿的ADCb0-900和ADCb150-900的曲线下面积、Cutoff值、敏感度、特异度和准确度分别为0.976、2.90×10^(-3)mm^(2)/s、100.00%、96.20%、96.20%和0.976、2.35×10^(-3)mm^(2)/s、100.00%、96.20%、96.20%。结论ADCb0-900和ADCb150-900均能对胸腺囊肿、低、高风险胸腺瘤进行鉴别诊断,ADCb150-900比ADCb0-900区分低、高风险胸腺瘤有更好的表现;DWI的区分能力明显高于MRI。Purpose To investigate the ability of apparent diffusion coefficient(ADC)b0-900 and ADCb150-900 in differentiating low-risk thymomas,high-risk thymoma and thymic cyst via diffusion weighted imaging(DWI)with the parameters of three b values.Materials and Methods From January 2017 to January 2020,26 low-risk thymomas,8 high-risk thymomas and 8 thymic cysts were prospectively enrolled in Xuanwu Hospital,Capital Medical University based on the postoperative pathological results.Conventional magnetic resonance imaging and DWI were performed on all the patients.The ADC values of all the lesions on the ADCb0-900 and ADCb150-900 images were measured and the ADC reduction rate was calculated,respectively.Receiver operating characteristic curves were obtained to evaluate discrimination abilities of the ADCb0-900 and ADCb150-900 respectively.Results The average of ADCb0-900 for the three groups of low-risk,high-risk thymoma and thymic cysts were(2.04±0.50)×10^(-3)mm^(2)/s,(1.21±0.50)×10^(-3)mm^(2)/s and(3.52±0.54)×10^(-3)mm^(2)/s,respectively(P<0.001).The average of ADCb150-900 were(1.59±0.49)×10^(-3)mm^(2)/s,(0.82±0.15)×10^(-3)mm^(2)/s and(2.73±0.24)×10^(-3)mm^(2)/s,respectively(P<0.001).The area under Curve and optimal Cutoff of the ADCb0-900 and ADCb150-900 in discriminating low-risk and high-risk thymoma were 0.885 and 0.964,1.35×10^(-3)mm^(2)/s(sensitivity 96.20%,specificity 75.00%,accuracy 71.20%)and 1.06×10^(-3)mm^(2)/s(sensitivity 84.60%,specificity 100.00%,accuracy 84.60%),respectively.The area under curve and optimal Cutoff of the ADCb0-900 and ADCb150-900 in discriminating low-risk thymoma and thymic cyst were 0.976 equally,2.90×10^(-3)mm^(2)/s/s(sensitivity 100.00%,specificity 96.20%,accuracy 96.20%)and 2.35×10^(-3)mm^(2)/s(sensitivity 100.00%,specificity 96.20%,accuracy 96.20%),respectively.Conclusion ADCb0-900 and ADCb150-900 can attribute to differentiating low-risk thymoma,high-risk thymoma from thymic cyst compared with traditional MRI.Meanwhile,ADCb150-900 has a better performance than ADCb

关 键 词：胸腺囊肿 低风险胸腺瘤 高风险胸腺瘤 扩散加权成像 诊断 鉴别 

分 类 号：R736.3[医药卫生—肿瘤] R445.2[医药卫生—临床医学]