MRI多参数成像在腮腺良性肿瘤鉴别诊断中的价值  

Value of MRI multi-parameter imaging in differential diagnosis of benign parotid tumors

作　　者：李学兵 王交运 王晋 郭丽丽 王子逸 LI Xuebing;WANG Jiaoyun;WANG Jin;GUO Lili;WANG Ziyi(Department of Nuclear Medicine,Jincheng People’s Hospital,Jincheng,Shanxi Province 048026,China;Department of Medical Imaging,Jincheng People’s Hospital,Jincheng,Shanxi Province 048026,China)

机构地区：[1]晋城市人民医院核医学科,山西晋城048026 [2]晋城市人民医院医学影像科,山西晋城048026

出　　处：《实用放射学杂志》2023年第12期1931-1935,共5页Journal of Practical Radiology

摘　　要：目的探讨MRI多参数特征在腮腺良性肿瘤鉴别诊断中的价值。方法回顾性分析123例患者144个病灶MRI检查数据;根据病理结果,将病例分为多形性腺瘤(PA)组(90例)和非PA组(33例)。对2组患者的性别、部位、MRI信号、动态增强类型等进行对比分析。结果年龄、性别、囊变、T_(1)WI信号、T_(2)WI信号、时间-信号强度曲线(TIC)类型、病灶位置、边缘和表观扩散系数(ADC)值在2组患者中差异有显著意义(P<0.05)。性别(女)、T_(2)高信号和ADC值均与PA的病理结果具有较好的一致性(Kappa值分别为0.62、0.62、0.78,P<0.05)。受试者工作特征(ROC)曲线分析显示ADC值和峰时间(T_(peak))具有良好的鉴别诊断价值,曲线下面积(AUC)(AUCADC和AUCT_(peak))分别为0.97[95%置信区间(CI)0.92~1.00)]、0.76(95%CI 0.52~0.97)。ADC截断值为1.03×10^(-3)mm^(2)/s,敏感性为85.71%,特异性为100.00%;T_(peak)截断值为102 s,敏感性为71.43%,特异性为75.00%。联合两者进行鉴别诊断时,AUC为0.92(95%CI 0.92~1.00),敏感性为92.86%,特异性为87.50%。结论多参数MRI影像特征的综合分析能够提高腮腺良性肿瘤鉴别诊断的准确率,有助于制订个体化治疗方案。Objective To investigate the value of multi-parameter features based on MRI in the differential diagnosis of benign parotid tumors.Methods Retrospective analysis was conducted on the MRI data of 144 lesions in 123 patients.According to the pathological results,all cases were divided into pleomorphic adenoma(PA)group(n=90)and non-PA group(n=33).The gender,location,MRI signal and dynamic enhancement types of the two groups were compared and analyzed.Results There were all significant differences in age,gender,cystic degeneration,T_(1)WI,T_(2)WI signals,types of time-signal intensity curve(TIC),lesion location,edge and apparent diffusion coefficient(ADC)values between PA and non-PA groups(P<0.05).Gender(female),T_(2)high signal and ADC values were in good agreement with the pathological results in PA(Kappa value was 0.62,0.62,0.78,respectively,P<0.05).The receiver operating characteristic(ROC)curve showed that ADC value and T_(peak)had good differential diagnostic value.Area under the curve(AUC)(AUCADC and AUCT_(peak))were 0.97[95%confidence interval(CI)0.92-1.00]and 0.76(95%CI 0.52-0.97),respectively.Cut-off value of ADC was 1.03×10^(-3)mm^(2)/s,and sensitivity and specificity was 85.71%and 100.00%,respectively.Cut-off value of T_(peak)was 102 s,and sensitivity and specificity was 71.43%and 75.00%,respectively.When the two parameters were combined for differential diagnosis,the AUC was 0.92(95%CI 0.92-1.00),and the sensitivity and specificity was 92.86%and 87.50%,respectively.Conclusion The comprehensive analysis of multi-parameter imaging features based on MRI can improve the accuracy of differential diagnosis of benign parotid tumors and help to formulate individualized treatment plans.

关 键 词：磁共振成像 多形性腺瘤 扩散加权成像 诊断价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.81[医药卫生—诊断学]