合成MRI鉴别T1期鼻咽癌与鼻咽淋巴组织增生的价值  

Synthetic MRI in differential diagnosis of stage T1 in patients with nasopharyngeal carcinoma and lymphoid hyperplasia

作　　者：张衡 胡林 葛宇曦[1] 钟妍其 常军 窦维强 胡曙东 王鹏 ZHANG Heng;HU Lin;GE Yuxi;ZHONG Yanqi;CHANG Jun;DOU Weiqiang;HU Shudong;WANG Peng(Department of Medical Imaging,the Affiliated Hospital of Jiangnan University,Wuci,Jiangsu Province 214122,China;Department of Otolaryngology,the Affiliated Hospital of Jiangnan University,Wuci,Jiangsu Province 214122,China;GE Healthcare,MR Research China,Beijing 100176,China)

机构地区：[1]江南大学附属医院医学影像科,江苏无锡214122 [2]江南大学附属医院耳鼻喉科,江苏无锡214122 [3]GE医疗磁共振科研部,北京100176

出　　处：《实用放射学杂志》2023年第9期1401-1404,1408,共5页Journal of Practical Radiology

基　　金：江苏省科技计划项目(BK20221203);无锡市科技发展资金项目(Y20212020)。

摘　　要：目的探讨合成磁共振成像(syMRI)在鉴别T_(1)期鼻咽癌(NPC_(T1))与鼻咽淋巴组织增生(NPLH)中的价值.方法回顾性分析经病理确诊的54例鼻咽部病变,NPC_(T1)34例,NPLH 20例.所有患者术前均接受syMRI序列扫描,扫描结束后测量病灶以及头长肌的纵向弛豫时间(T_(1))、横向弛豫时间(T_(2))、质子密度(PD),获得T_(1)比值、T_(2)比值以及PD比值(病灶/头长肌).采用独立样本t检验和Mann-Whitney U检验比较2组间定量参数差异,受试者工作特征(ROC)曲线确定最佳临界值及诊断效能,DeLong检验分析不同定量参数在鉴别NPC_(T1)和NPLH的曲线下面积(AUC)差异.结果NPC_(T1)的T_(2)、PD、T_(2)比值、PD比值显著低于NPLH(P<0.05),T_(1)、T_(1)比值在2组间无统计学差异(P>0.05).在所有定量参数中,T_(2)值的诊断效能最佳,AUC值为0.876,敏感度、特异度、阳性预测值及阴性预测值分别为85.00%、79.41%、87.50%、72.70%.联合T_(2)、PD、T_(2)比值、PD比值可使鉴别两者的AUC值提高到0.951,敏感度、特异度、阳性预测值及阴性预测值分别为91.18%、90.00%、93.90%及85.70%.结论syMRI定量参数(T_(2)、PD、T_(2)比值、PD比值)有助于鉴别NPC_(T1)和NPLH,联合这些定量参数可有效提高两者的鉴别诊断效能.Objective To investigate the value of synthetic magnetic resonance imaging(syMRI)in differentiating stage T_(1)naso-pharyngeal carcinoma(NPC_(T1))from nasopharyngeal lymphoid hyperplasia(NPLH).Methods Fifty-four patients with pathologically confirmed nasopharyngeal lesions(NPC_(T1),n=34;NPLH,n=20)were analyzed retrospectively.All patients underwent preop-eratively syMRI scans.The quantitative parameters of nasopharyngeal lesions and longus capitis were measured,including T_(1)relaxation time,T_(2)relaxation time,proton density(PD).T_(1)ratio,T_(2)ratio and PD ratio were calculated via dividing T_(1),T_(2),PD values of nasopharyngeal lesions and longus capitis.Independent sample t-test and Mann-Whitney U test were performed to compare the quan-titative parameters.Receiver operating characteristic(ROC)curve was used to determine the optimal critical value and diagnostic efficiency.DeLong test was used to compare the area under the curve(AUC)values for discriminating NPC_(T1)and NPLH.Results The T_(1),PD,T_(2)ratio and PD ratio values of NPC_(T1)were significantly lower than those of NPLH(P<0.05),whereas T_(1)and T_(1)ratio showed no statistical difference between these two groups(P>0.05).T_(2)value had the best diagnostic performance among all quantitative parameters,with AUC,sensitivity,specificity,positive and negative predictive values of 0.876,85.00%,79.41%,87.50%,and 72.70%,respectively.The combined T_(2),PD,T_(2)ratio,and PD ratio could further improve the diagnostic efficiency,with AUC,sensitivity,specificity,positive and negative predictive values of 0.951,91.18%,90.00%,93.90%,and 85.70%,respectively.Conclusion SyMRI quantitative parameters(T_(2),PD,T_(2)ratio,PD ratio)can be helpful in distinguishing NPC_(T1)from NPLH,effectively improving the differential diagnostic efficiency via the combination of these quantitative parameters.

关 键 词：鼻咽癌 鼻咽淋巴组织增生 合成磁共振成像 

分 类 号：R739.63[医药卫生—肿瘤] R766.3[医药卫生—临床医学] R445.2