扩散加权联合动态对比增强磁共振成像鉴别诊断腮腺良恶性肿瘤

发布时间：2018-03-17 16:22

本文选题：腮腺肿瘤　切入点：对比剂　出处：《中国医学影像技术》2017年08期 　论文类型：期刊论文

【摘要】：目的探讨DWI联合动态对比增强磁共振成像(DCE-MRI)在腮腺良恶性肿瘤鉴别诊断中的价值。方法收集90例腮腺肿瘤患者共94个病灶,其中良性75个、恶性19个。对所有患者术前均行DWI和DCE-MRI检查,分析各病灶的ADC值和时间-信号强度曲线(TIC)类型。绘制ROC曲线,比较ADC值、TIC及两者联合对腮腺良恶性肿瘤的鉴别诊断效能。结果恶性肿瘤的ADC值[(1.02±0.25)×10~(-3) mm~2/s]显著低于良性肿瘤的ADC值[(1.38±0.44)×10~(-3) mm~2/s;t=5.170,P0.001]。将表现为A型(流入型)、B型(廓清型)和D型(平坦型)曲线判为良性肿瘤、C型(平台型)曲线判为恶性肿瘤时,诊断腮腺肿瘤良恶性的敏感度为0.62,特异度为0.92;C型曲线患者中,以ADC1.36×10~(-3) mm~2/s诊断恶性肿瘤时,敏感度为0.92,特异度为0.95。结论良恶性腮腺肿瘤间ADC值存在重叠,鉴别诊断时不应单纯依赖DWI;TIC表现为A、B、D型多提示良性肿瘤,C型常提示恶性肿瘤;TIC曲线为C型时,联合ADC值可明显提高对良恶性肿瘤的鉴别诊断效能。
[Abstract]:Objective to investigate the value of DWI combined with dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in differential diagnosis of parotid benign and malignant tumors. All the patients were examined with DWI and DCE-MRI before operation. The ADC value and time-signal intensity curve (TICs) of all lesions were analyzed. The ROC curves were plotted. Results the ADC value of malignant tumors [1.02 卤0.25 脳 10 ~ (-3)) mm~2/s] was significantly lower than that of benign tumors [1.38 卤0.44) 脳 10 ~ (-4) mm ~ (-1) ~ (2) / s ~ (-1) T _ (5.170P0.001)]. When a (flat) curve is defined as a benign tumor, a C (plateau) curve is a malignant tumor, In the patients with benign and malignant parotid tumors, the sensitivity and specificity of mm~2/s were 0.92 and 0.95.Conclusion there is overlap in ADC between benign and malignant parotid tumors. In differential diagnosis, we should not rely solely on DWII-TIC for diagnosis of benign and malignant tumors. The combined ADC value can significantly improve the differential diagnosis of benign and malignant tumors when the TIC curve of benign tumors is often indicated to be type C, and the diagnosis of benign and malignant tumors can be improved by combining ADC value.
【作者单位】：苏州大学附属第一医院影像科;贵州医科大学附属医院影像科;
【分类号】：R445.2;R739.8

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