磁共振扩散峰度成像鉴别不同腮腺疾病及诊断腮腺腺淋巴瘤的应用

发布时间：2018-03-03 19:23

本文选题：腮腺疾病　切入点：腺淋巴瘤　出处：《中国医学影像技术》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨磁共振扩散峰度成像(DKI)鉴别不同类型腮腺疾病及诊断腮腺腺淋巴瘤(PAL)的价值。方法回顾性分析57例腮腺疾病患者的DKI及DWI资料,分为感染性病变组(n=10)、混合瘤组(n=19)、PAL组(n=14)、其他良性肿瘤组(n=4)、恶性肿瘤组(n=10)。并将其中19例单侧腮腺病变患者的对侧正常腮腺作为正常对照组。比较各组病灶DKI扩散峰度系数(K_(mean)、K_(rad)、K_(ax))、扩散系数(D_(mean)、D_(rad)、D_(ax))、FA值及传统ADC值的差异。采用二分类Logistic回归筛选在PAL的诊断中具有统计学意义的指标,建立Logistic回归方程。绘制ROC曲线对筛选后的指标及二分类Logistic回归模型的诊断效能进行分析。结果各组间K_(mean)、K_(rad)、K_(ax)、D_(mean)、D_(rad)、D_(ax)、FA及ADC值的差别均有统计学意义(P均0.05)。ROC曲线分析显示,FA联合K_(ax)值诊断PLA的曲线下面积(AUC)为0.88±0.06(0.79~0.94),高于单纯K_(ax)[0.80±0.07(0.70~0.88)]和FA的AUC[0.63±0.10(0.52~0.73)],差异均有统计学意义(P均0.05);其敏感度、特异度、准确率、阳性预测值、阴性预测值分别为71.43%、95.78%、91.77%、76.92%、94.44%。结论 DKI可用于鉴别不同类型腮腺疾病,联合应用FA及K_(ax)值有利于提高对PAL的诊断能力。
[Abstract]:Objective to evaluate the value of diffusive kurtosis imaging (DKI) in differentiating different types of parotid diseases and in diagnosing parotid gland lymphoma. Methods the DKI and DWI data of 57 patients with parotid gland disease were retrospectively analyzed. It was divided into infectious lesion group (n = 10), mixed tumor group (n = 19) and pal group (n = 14), other benign tumor group (n = 4) and malignant tumor group (n = 10). The contralateral normal parotid gland of 19 patients with unilateral parotid gland disease was used as normal control group. The diffusion kurtosis of DKI in each group was compared. The diffusivity coefficient is the difference between the FA value and the traditional ADC value of PAL. A statistically significant indicator in the diagnosis of PAL is selected by using the two-classification Logistic regression method. The Logistic regression equation was established and the ROC curve was drawn to analyze the diagnostic effectiveness of the selected indexes and the two classification Logistic regression models. Results the results showed that there were significant differences in the values of ADC and ADC between the groups. The area under the curve for the diagnosis of PLA was 0.88 卤0.06, 0.79, 0.94, which was higher than that for Kapa (0.80 卤0.07, 0.70, 0.88) and FA (AUC, 0.63 卤0.100.52, 0.73). The difference was statistically significant (P < 0.05), and the sensitivity was significant. The specificity, accuracy, positive predictive value and negative predictive value were 71.43 and 95.7878 and 91.77, 76.92 and 94.444.Conclusion DKI can be used to distinguish different types of parotid gland diseases, and the combination of FA and Kapax can improve the diagnostic ability of PAL.
【作者单位】：福建医科大学省立临床学院福建省立医院放射科;西门子中国有限公司医学诊断产品事业部;
【基金】：福建省卫生厅青年科研课题资助计划(2013-1-3)
【分类号】：R739.8;R445.2

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