磁共振弥散加权成像及动态对比增强磁共振成像鉴别诊断腮腺肿瘤的临床观察  

Clinical Observation of Diffusion-weighted Magnetic Resonance Imaging and Dynamic Contrast-enhanced Magnetic Resonance Imaging for Differential Diagnosis of Parotid Gland Tumors

作　　者：卫孟佳 王嘉麟 王梦莹 张博文 吉小曦 WEI Meng-jia;WANG Jia-lin;WANG Meng-ying;ZHANG Bo-wen;JI Xiao-xi(Department of Imaging,Qinhuangdao Hospital,Peking University third Hospital,Qinhuangdao 066000,Hebei Province,China)

机构地区：[1]北京大学第三医院秦皇岛医院影像科,河北秦皇岛066000

出　　处：《中国CT和MRI杂志》2025年第2期60-62,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨腮腺肿瘤诊断应用磁共振弥散加权成像(DWI)及动态对比增强磁共振成像(DCE-MRI)的价值。方法选取2021年5月至2024年5月在我院治疗的腮腺肿瘤患者70例,所有患者均给予DWI、DCE-MRI检查,以病理检查结果为“金标准”,分析DWI、DCE-MRI诊断腮腺肿瘤的价值。结果70例患者,最终病理检查确诊恶性病变21例,良性病变49例。DWI、DCE-MRI与病理结果一致性Kappa值分别为0.371和0.613,P<0.05,可见DWI与病理结果一致性较差。DCE-MRI诊断恶性病变的灵敏性、特异性、准确率、阳性预测值和阴性预测值分别为80.95%、83.67%、82.86%、68.00%和91.11%,高于DWI检查,但差异比较无统计学意义(P>0.05)。恶性病变表观扩散系数(ADC)值和相对表观扩散系数(rADC)分别为(0.95±0.27)×10^(-3)mm^(2)/s和(0.40±0.15),低于良性病变(P<0.05)。恶性病变TIC曲线C型比例较高,达到57.14%;恶性病变容积分数(Ve)为(0.24±0.09),低于良性病变(P<0.05)。结论相较于DWI,DCE-MRI鉴别诊断腮腺肿瘤的价值较好;DWI、DCE-MRI均可提供客观数据用于腮腺肿瘤良恶性病变的鉴别。Objective To explore the value of diffusion-weighted imaging(DWI)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the differential diagnosis of parotid gland tumors.Methods 70 patients with parotid tumors were treated in our hospital from May 2021 to May 2024,and all patients received DWI and DCE-MRI.Using the pathological examination results as the gold standard,the value of DWI and DCE-MRI for the diagnosis of parotid tumors was analyzed.Results In 70 patients,21 were ultimately diagnosed with malignant lesions and 49 with benign lesions through pathological examination.The Kappa values for the consistency between DWI,DCE-MRI,and pathological results were 0.371 and 0.613,respectively,with P<0.05,indicating poor consistency between DWI and pathological results.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of DCE-MRI in diagnosing malignant lesions were 80.95%,83.67%,82.86%,68.00%,and 91.11%,respectively,which were higher than DWI examination,but the difference was not statistically significant(P>0.05).The apparent diffusion coefficient(ADC)value and relative apparent diffusion coefficient(rADC)of malignant lesions were(0.95±0.27)×10^(-3)mm^(2)/s and(0.40±0.15),respectively,which were lower than those of benign lesions(P<0.05).The proportion of type C TIC curve in malignant lesions was relatively high,reaching 57.14%.The volume fraction(V_e)of malignant lesions was(0.24±0.09),which was lower than that of benign lesions(P<0.05).Conclusion Compared with DWI,DCE-MRI has better value in the differential diagnosis of parotid gland tumors.DWI and DCE-MRI can both provide objective data for the differentiation of benign and malignant lesions in parotid gland tumors.

关 键 词：磁共振弥散加权成像 动态对比增强磁共振成像 腮腺肿瘤 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]