磁共振扩散加权成像鉴别诊断鼻腔、鼻窦实性肿块的适宜b值

发布时间：2018-07-28 19:24

【摘要】：目的探讨MR DWI鉴别诊断鼻腔、鼻窦实性肿块的适宜b值。方法对61例鼻腔、鼻窦肿块患者术前行常规MR及DWI扫描,选取b值为500、1000 s/mm~2,测量病变实性部位ROI的ADC值,将结果与组织病理学结果对照。比较良恶性病变ADC值的差异。分别在两种b值下以鼻腔、鼻窦良恶性肿块的ADC值作为临界点绘制ROC曲线,计算曲线下面积(Az),确定诊断阈值,评价诊断效能并进行比较。结果b=500 s/mm~2时,21例恶性肿块和40例良性肿块的平均ADC值为(1.07±0.32)×10~(-3)mm~2/s、(1.90±0.62)×10~(-3)mm~2/s(P0.001),Az为O.929,以ADC值:1.31×10~(-3)mm~2/s作为预测鼻腔、鼻窦良恶性病变的诊断阈值,其敏感度为85.7%,特异度为95.0%,准确率为91.8%。b=1000 s/mm~2时。21例恶性肿块和40例良性肿块的平均ADC值分别为(0.86±0.25)×10~(-3)mm~2/s、(1.55±0.41)×10~(-3)mm~2/s(P0.001),Az为0.963.以ADC值=1.10×10~(-3)mm~2/s作为预测鼻腔鼻窦良恶性病变的诊断阈值,其敏感度为85.7%.特异度为97.5%,准确率为93.1%;两组b值的Az间差异无统计学意义(P0.05)。b=500 s/mm~2时的图像信噪比明显高于b=1000 s/mm~2的信噪比。结论 b=500 s/mm~2时在保证更好图像质量的同时具有较好的诊断效能,更适宜鼻腔、鼻窦肿块的鉴别诊断。
[Abstract]:Objective to investigate the appropriate b value of Mr DWI in differential diagnosis of solid masses of nasal cavity and sinuses. Methods Sixty-one patients with nasal cavity and sinus mass were examined with conventional Mr and DWI before operation. The ADC value of ROI was measured with b value of 500 ~ 1000s / mm ~ (-2). The results were compared with histopathological results. To compare the difference of ADC value in benign and malignant lesions. The ADC value of benign and malignant masses of nasal cavity and sinuses was used as the critical point to draw ROC curves under two b values, and the area under the curve was calculated to determine the diagnostic threshold, and the diagnostic efficacy was evaluated and compared. Results the mean ADC values of 21 malignant masses and 40 benign masses were (1.07 卤0.32) 脳 10 ~ (-3) mm ~ (-3) / s, (1.90 卤0.62) 脳 10 ~ (-3) mm~2/s (P ~ (0.001) Az = 0.929. The ADC value of 1.31 脳 10 ~ (-3) mm~2/s was used to predict nasal cavity, and the diagnostic threshold of benign and malignant lesions of nasal sinus was (1.90 卤0.62) 脳 10 ~ (-3) mm~2/s. The sensitivity was 85.7, the specificity was 95.0 and the accuracy was (0.86 卤0.25) 脳 10 ~ (-3) mm ~ (-3) / s, (1.55 卤0.41) 脳 10 ~ (-3) mm~2/s (P ~ 0.001) Az = 0.963, respectively. The average ADC values of 21 cases of malignant masses and 40 cases of benign masses were (0.86 卤0.25) 脳 10 ~ (-3) mm ~ (-3) / s and (1.55 卤0.41) 脳 10 ~ (-3) mm~2/s (P ~ (0.001), respectively. Using the ADC value of 1.10 脳 10 ~ (-3) mm~2/s as the diagnostic threshold for predicting benign and malignant lesions of nasal cavity and paranasal sinuses, the sensitivity was 85.7. The specificity was 97.5 and the accuracy was 93.1. There was no significant difference between the two groups (P0.05). The signal-to-noise ratio (SNR) of the image was significantly higher than that of bP1000 s/mm~2 (P0.05). Conclusion 500 s / mm ~ 2 of BX has better diagnostic efficacy and is more suitable for differential diagnosis of nasal and sinus masses as well as ensuring better image quality.
【作者单位】：首都医科大学附属北京同仁医院放射科;
【基金】：北京卫生高层次人才学科骨干资助(2011-3-048)
【分类号】：R445.2;R739.62

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