磁共振动态增强联合扩散加权成像鉴别鼻窦良恶性肿块的价值

发布时间：2017-12-28 20:17

本文关键词：磁共振动态增强联合扩散加权成像鉴别鼻窦良恶性肿块的价值　出处：《临床放射学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨磁共振扩散加权成像(DWI)、动态增强(DCE-MRI)二者联合鉴别诊断鼻窦肿块良恶性的价值。方法回顾性分析81例经病理证实鼻窦肿块(良性42例,恶性39例)的DWI和DCE-MRI特点,观察病灶大小、信号特征、强化方式,统计ADC值、时间-信号曲线(TIC)类型、达峰时间(TTP)、最大对比增强率(MCER)、增强峰值(EP),分别比较良恶性组参数(ADC、TTP、MCER、EP),采用多因素Logistic回归分析确定DWI与DCE-MRI联合诊断鼻窦肿块的独立影响因素,以病理结果为金标准,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)并比较。结果纳入Logistic回归方程独立影响因素为ADC、MCER。DWI(ADC)、DCE-MRI(MCER、EP、TTP)及二者参数联合鉴别鼻窦良恶性肿块的敏感度、特异度分别为87.2%、88.1%;74.4%、64.3%;59%、59.5%;46.2%、76.2%;94.9%、92.9%。三种方法 AUC分别为0.936;0.712、0.619、0.364;0.958。结论 DWI联合DEC-MRI可以提高鼻窦良恶性肿块鉴别诊断效能。
[Abstract]:Objective to explore the value of differential diagnosis of benign and malignant paranasal masses by magnetic resonance diffusion-weighted imaging (DWI) and dynamic enhancement (DCE-MRI) two. Methods a retrospective analysis of 81 patients with pathologically confirmed sinus tumors (42 cases of benign and malignant 39 cases) of DWI and DCE-MRI, observed lesion size, signal characteristics, signal enhancement, ADC value and time curve (TIC), time to peak (TTP), the maximum contrast enhancement ratio (MCER), the peak enhancement (EP), benign and malignant group parameters were compared (ADC, TTP, MCER, EP), using multi factor analysis to identify independent risk factors of DWI combined with DCE-MRI in diagnosis of paranasal sinus neoplasms Logistic regression, with pathological results as the gold standard receiveroperating characteristic (ROC) curve, the area under the curve calculation (AUC) and. Results the independent influence factors included in the Logistic regression equation were ADC and MCER. The sensitivity and specificity of DWI (ADC), DCE-MRI (MCER, EP, TTP) and two parameters in differentiating benign and malignant tumors of nasal sinus were 87.2% and 88.1%, 74.4%, 64.3%, 59%, 59.5%, 46.2%, 76.2%, 94.9% and 92.9%, respectively. The three methods, AUC, were 0.936, 0.712, 0.619, 0.364, 0.958. Conclusion DWI combined with DEC-MRI can improve the differential diagnosis of benign and malignant paranasal sinus.
【作者单位】：郑州大学第一附属医院磁共振科;
【分类号】：R445.2;R739.62
【正文快照】： 鼻窦解剖关系复杂,其内肿块约占头颈部肿瘤10%[1]且种类繁多,部分类型缺乏特征性影像表现,因此及时区分病变性质对治疗方案及预后有重要意义。磁共振检查具有软组织分辨率高的特点[2],有助于明确病变性质。本研究旨在探讨磁共振动态增强(DCE-MRI)及扩散加权成像(DWI)鉴别鼻

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