DWI联合T2 mapping对腮腺肿瘤的定性诊断价值  

Value of qualitative diagnosis in parotid gland tumors combined with DWI and T_(2)mapping

作　　者：李治群[1] 徐钐 孙笑芬 万江花[1] 刘旭东[1] 李蕊蕊 邹嘉琦 施玉森[1] LI Zhiqun;XU Shan;SUN Xiaofen;WAN Jianghua;LIU Xudong;LI Ruirui;ZOU Jiaqi;SHI Yusen(Department of Radiology,the First Affiliated Hospital of Hainan Medical University,Hainan 570102,China)

机构地区：[1]海南医学院第一附属医院放射科,海南海口570102

出　　处：《影像诊断与介入放射学》2023年第4期273-277,共5页Diagnostic Imaging & Interventional Radiology

基　　金：海南省自然科学基金高层次人才项目(822RC824)。

摘　　要：目的探讨扩散加权成像(DWI)联合横向弛豫时间成像(T_(2)mapping)对腮腺良、恶性肿瘤的鉴别诊断价值。方法收集82例经手术确诊的腮腺肿瘤患者,所有患者术前均行MRI检查,包括平扫、DWI和T_(2)mapping序列。采用Logistic线性回归法回顾性分析ADC值和T_(2)值作为单一参数和联合参数区分腮腺良、恶性肿瘤的诊断效能。结果82例腮腺肿瘤中良性肿瘤54例(65.9%)、恶性肿瘤28例(34.1%)。良性肿瘤的平均ADC值为(1.16±0.30)×10^(-3)mm^(2)/s,平均T_(2)值为(95.6±30.6)ms,而恶性肿瘤的平均ADC值为(0.97±0.18)×10^(-3)mm^(2)/s,平均T_(2)值为(65.5±12.7)ms。良、恶性肿瘤的ADC值和T_(2)值之间均具有统计学差异(P<0.05)。根据ROC曲线分析,ADC值和T_(2)值作为独立参数和联合参数区分腮腺肿瘤的AUC分别为0.73、0.79和0.89,敏感度和特异度分别为85.7%、66.7%、89.3%和61.1%、85.7%、92.6%。ADC值与T_(2)值的联合参数诊断效能高于ADC值的单一参数(P<0.05)。结论DWI联合T_(2)mapping可提高鉴别腮腺良、恶性肿瘤的效能,可作为钆剂增强禁忌患者的替代检查方案。Objective To explore the differential diagnostic value of benign and malignant parotid gland tumors combined with diffusion weighted imaging(DWI)and T_(2)mapping.Methods 82 patients with surgically confirmed parotid gland tumors,all of whom underwent preoperative MRI examinations consisting of plain scan,DWI and T_(2)mapping sequences.Logistic linear regression analysis was used to retrospectively analyze the diagnostic efficacy of apparent diffusion coefficient(ADC)value and T_(2)value as an individual and combined parameter in differentiating benign and malignant parotid tumors.Results Among 82 cases of parotid gland tumors,54 cases(65.9%)were diagnosed as benign tumors and 28 cases(34.1%)were malignant ones.The average ADC value of benign tumors was measured at(1.16±0.30)×10^(-3)mm^(2)/s,accompanied by an average T_(2)relaxation time of(95.6±30.6)ms.Conversely,malignant tumors exhibited an average ADC value of(0.97±0.18)×10^(-3)mm^(2)/s and an average T_(2)relaxation time of(65.5±12.7)ms.There were statistically significant differences observed in the ADC values and T_(2)values between benign and malignant tumors(P<0.05).The receiver operating characteristic curve analysis revealed that the area under the curve(AUC)for ADC value,T_(2)value,and their combination to distinguish parotid tumors were 0.73,0.79,and 0.89,respectively.The corresponding sensitivity and specificity rates were 85.7%,66.7%,89.3%and 61.1%,85.7%,92.6%,respectively.Furthermore,the diagnostic efficacy of combining ADC value with T_(2)value was significantly higher than that of using ADC value alone(P<0.05).Conclusion DWI combined with T_(2)mapping can improve efficacy in distinguishing benign and malignant parotid gland tumors,serving as a viable alternative to preoperative examination for patients with contraindications to gadolinium enhancement.

关 键 词：腮腺肿瘤 磁共振成像 扩散加权成像 横向弛豫时间成像 定性诊断 

分 类 号：R739.87[医药卫生—肿瘤] R445.2[医药卫生—临床医学]