鼻腔鼻窦腺样囊性癌扩散加权成像特征及其诊断肿瘤浸润神经价值

发布时间：2018-09-10 20:19

【摘要】：目的探讨鼻腔鼻窦腺样囊性癌(ACC)DWI特征及DWI诊断肿瘤浸润神经的能力。方法回顾性分析19例经病理证实的鼻腔鼻窦腺ACC常规MRI及DWI资料,观察MRI及DWI特征,以病理结果为金标准,比较二者诊断肿瘤浸润神经的敏感度、特异度和准确率差异。结果平扫MRI:T1WI低信号5例(5/19,26.32%),等信号14例(14/19,73.68%),8例(8/19,42.11%)信号不均匀;T2WI高信号6例(6/19,31.58%),等信号13例(13/19,68.42%),15例(15/19,78.95%)不均匀;增强MRI:1例(1/19,5.26%)均匀强化、18例(18/19,94.74%)不均匀强化,中度强化11例(11/19,57.89%)、明显强化8例(8/19,42.11%)。DWI:等信号6例(6/19,31.58%),低信号12例(12/19,63.16%),略高信号1例(1/19,5.26%)。平扫和增强MRI诊断神经浸润的敏感度、特异度及准确率分别为54.55%(6/11)、87.50%(7/8)、68.42%(13/19)和90.91%(10/11)、87.50%(7/8)和89.47%(17/19),DWI诊断神经浸润的敏感度、特异度及准确率分别为81.82%(9/11)、75.00%(6/8)和78.95%(15/19),其准确率高于平扫MRI(P0.05),低于增强MRI(P0.05)。结论鼻腔鼻窦ACC的DWI表现具有一定特征,且对于诊断ACC神经浸润具有重要价值。
[Abstract]:Objective to investigate the (ACC) DWI features of adenoid cystic carcinoma of nasal cavity and paranasal sinuses and the ability of DWI to diagnose tumor infiltrating nerves. Methods the data of ACC routine MRI and DWI in 19 cases of nasal cavity and paranasal sinus gland confirmed by pathology were retrospectively analyzed, and the characteristics of MRI and DWI were observed. The sensitivity, specificity and accuracy of the two methods in the diagnosis of tumor infiltrating nerves were compared by using the pathological results as gold standard. Results MRI:T1WI showed low signal intensity in 5 cases (5 / 19 / 26.32%), isointensity in 14 cases (14 / 1973.68%), heterogeneous signal intensity in 8 cases (8 / 19 / 42.11%), high signal intensity on T _ 2WI in 6 cases (6 / 19 ~ 31.58%), iso-signal in 13 cases (13 / 19, 68.42%) in 15 cases (15 / 19 / 78.95%), homogeneous enhancement in 18 cases (18 / 19, 94.74%) and enhanced MRI:1 in 18 cases (18 / 19, 94.74%), respectively. 11 cases (11 / 19) showed moderate enhancement (57.89%), 8 cases (8 / 19% 42.11%). DWI: isointensity 6 cases (6 / 19 31. 58%), low signal 12 cases (12 / 19) 63.16%, slightly hyperintense 1 case (1 / 195.26%). The sensitivity, specificity and accuracy of plain scan and enhanced MRI in the diagnosis of neural invasion were 54.55% (6 / 11) and 68.42% (13 / 19) and 90.91% (10 / 11), 87.50% (7/ 8) and 89.47% (17 / 19), respectively. The sensitivity, specificity and accuracy of MRI were 81.82% (65.00%) and 78.95% (15 / 19), respectively, which were higher than those of plain scan MRI (P0.05) and enhanced MRI (P0.05). Conclusion the DWI features of ACC in nasal cavity and paranasal sinus have some characteristics and have important value in the diagnosis of ACC nerve infiltration.
【作者单位】：首都医科大学附属北京同仁医院放射科;鼻病研究北京市重点实验室;
【基金】：北京市优秀人才培养资助D类(2010D003034000033) 北京市卫生系统高层次卫生技术人才学科骨干(2011-3-047) 北京市自然科学基金(7112030)
【分类号】：R739.62;R445.2

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