基于磁共振快速自旋回波弥散加权成像序列对鼻腔鼻窦病变的诊断价值  

Value of turbo spin-echo diffusion-weighted imaging sequence in the diagnosis of nasal cavity and paranasal sinus diseases

作　　者：霍明新 王淑梅[2] 刘冲[2] 张建军[2] HUO Mingxin;WANG Shumei;LIU Chong;ZHANG Jianjun(Graduate School of Chengde Medical College,Chengde 067000,China;Department of Medical Imaging,Baoding First Central Hospital,Baoding 071000,China)

机构地区：[1]承德医学院研究生学院,河北承德067000 [2]保定市第一中心医院医学影像科,河北保定071000

出　　处：《分子影像学杂志》2024年第1期64-70,共7页Journal of Molecular Imaging

摘　　要：目的 前瞻性比较快速自旋回波弥散加权成像(TSE-DWI)与平面回波弥散加权成像(EP-DWI)对鼻腔鼻窦病变图像质量差异,探讨TSE-DWI及EP-DWI的表观扩散系数(ADC)值鉴别鼻腔鼻窦良恶性病变的诊断价值。方法 前瞻性选取2022年10月~2023年8月在我院诊治鼻腔鼻窦病变的93例患者作为研究对象,采用Philips 1.5T磁共振扫描仪进行扫描,所有患者行常规鼻腔鼻窦磁共振平扫后均行TSE-DWI及EP-DWI成像,通过2位医师对TSE-DWI与EP-DWI图像进行主观评价及客观评价来对比图像质量,评价2位医师间的一致性、两种DWI序列ADC值一致性及Pearson相关系数,比较鼻腔鼻窦良恶性病变ADC值的差异并使用ROC曲线计算ADC值鉴别鼻腔鼻窦良恶性病变的诊断效能。结果 TSE-DWI图像的各项主观评分值、信噪比均值和对比噪声比均值均高于EP-DWI(P<0.05),TSE-DWI图像的变形率较EP-DWI降低(P<0.05);对于图像主观评分,两医师间的一致性较好(Kappa>0.4);对于ADC值测量,两医师间的一致性极好(ICC>0.74);两种DWI序列ADC值一致性极好(ICC>0.74)并且呈极强正相关(Pearson相关系数>0.8);良恶性病变的ADC值差异有统计学意义(P<0.05),两种DWI序列的ADC值鉴别鼻腔鼻窦良恶性病变的敏感度、特异性、阳性预测值、阴性预测值及准确率相同,分别为90.1%、90.9%、97.0%、74.1%、90.3%。结论 磁共振TSE-DWI序列可有效提高鼻腔鼻窦部位图像质量,适用于临床广泛应用;ADC值在鉴别鼻腔鼻窦良恶性病变中具有很高的诊断效能。Objective To prospectively compare the difference in image quality between turbo spin-echo diffusion-weighted imaging(TSE-DWI)and planar echo diffusion-weighted imaging(EP-DWI)for nasal sinus lesions.To investigate the diagnostic value of the apparent diffusion coefficient(ADC)values of TSE-DWI and EP-DWI in identifying benign and malignant nasal sinus lesions.Methods Ninety-three patients with nasal sinus lesions seen in our hospital from October 2022 to August 2023 were prospectively selected for the study.A Philips 1.5T MRI scanner was used for scanning,and all patients underwent TSE-DWI and EP-DWI imaging after routine nasal sinus MRI plain scanning.Image quality was compared through subjective and objective evaluation of TSE-DWI and EP-DWI images by two physicians.The agreement between the two physicians,the agreement between the ADC values of the two DWI sequences,and the Pearson correlation coefficient were evaluated.The differences in ADC values of benign and malignant nasal sinus lesions were compared and the diagnostic efficacy of ADC values for identifying benign and malignant nasal sinus lesions was calculated using ROC curves.Results The mean values of all subjective scores,signal-to-noise ratios and contrast-to-noise ratios of TSE-DWI images were higher than those of EP-DWI(P<0.05),and the distortion rate of TSE-DWI images was lower than that of EP-DWI(P<0.05).Regarding subjective scoring of images,the agreement between the two physicians was good(Kappa>0.4).For ADC value measurement,the agreement between two physicians was excellent(ICC>0.74).The agreement between the ADC values of the two DWI sequences was excellent(ICC>0.74)and showed a very strong positive correlation(Pearson's correlation coefficient>0.8).The difference in ADC values for benign and malignant lesions was statistically significant(P<0.05).The ADC values of the two DWI sequences had the same sensitivity,specificity,positive predictive value,negative predictive value and accuracy in identifying benign and malignant lesions of the n

关 键 词：鼻腔鼻窦病变 TSE-DWI EP-DWI 图像质量 良恶性病变 表观扩散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R765.4[医药卫生—诊断学]