磁共振成像
磁共振成像
자공진성상
CHINESE JOURNAL OF MAGNETIC RESONANCE IMAGING
2014年
3期
182-188
,共7页
磁共振成像,弥散%泪器%肿瘤
磁共振成像,瀰散%淚器%腫瘤
자공진성상,미산%루기%종류
Diffusion magnetic resonance imaging%Lacrimal Apparatus%Neoplasms
目的：评价3.0 T MR扩散加权成像(DWI)及表观扩散系数(ADC值)对良、恶性泪腺上皮性肿瘤的诊断价值。材料与方法回顾性分析42例经手术病理证实的泪腺上皮性肿瘤常规MRI、DWI影像特点及ADC值，包括良性肿瘤17例，恶性肿瘤25例。所有病例选取b=0、1000 s/mm2 DWI序列，测量病灶扩散受限最显著区的ADC值并做统计学分析，良恶性肿瘤的ADC值比较采用Mann-Whitney U检验，并绘制ADC值诊断良恶性泪腺上皮性肿瘤的受试者工作特征(ROC)曲线。结果42例肿瘤的平均ADC值为(0.965±0.191)×10-3 mm2/s，良性及恶性肿瘤的平均ADC值分别为：(1.142±0.096)×10-3 mm2/s及(0.845±0.140)×10-3 mm2/s，两者之间的ADC值差异具有统计学意义(Z=-4.754，P=0.000<0.01)。恶性泪腺上皮性肿瘤的扩散受限最显著区ADC值低于良性。ROC曲线下面积S=0.936±0.043, S＞0.9，利用ADC值鉴别诊断肿瘤良、恶性的准确度较高。以ADC≤0.968×10-3mm2/s作为鉴别良、恶性泪腺上皮性肿瘤的诊断界值，诊断恶性肿瘤的灵敏度为92%，特异度为94%，准确度93%。结论3.0 T DWI可以揭示泪腺上皮性肿瘤的扩散特征，有助于良、恶性泪腺上皮性肿瘤的鉴别诊断；通过对ADC值进行定量分析，为泪腺良、恶性上皮性肿瘤的鉴别诊断提供客观依据。
目的：評價3.0 T MR擴散加權成像(DWI)及錶觀擴散繫數(ADC值)對良、噁性淚腺上皮性腫瘤的診斷價值。材料與方法迴顧性分析42例經手術病理證實的淚腺上皮性腫瘤常規MRI、DWI影像特點及ADC值，包括良性腫瘤17例，噁性腫瘤25例。所有病例選取b=0、1000 s/mm2 DWI序列，測量病竈擴散受限最顯著區的ADC值併做統計學分析，良噁性腫瘤的ADC值比較採用Mann-Whitney U檢驗，併繪製ADC值診斷良噁性淚腺上皮性腫瘤的受試者工作特徵(ROC)麯線。結果42例腫瘤的平均ADC值為(0.965±0.191)×10-3 mm2/s，良性及噁性腫瘤的平均ADC值分彆為：(1.142±0.096)×10-3 mm2/s及(0.845±0.140)×10-3 mm2/s，兩者之間的ADC值差異具有統計學意義(Z=-4.754，P=0.000<0.01)。噁性淚腺上皮性腫瘤的擴散受限最顯著區ADC值低于良性。ROC麯線下麵積S=0.936±0.043, S＞0.9，利用ADC值鑒彆診斷腫瘤良、噁性的準確度較高。以ADC≤0.968×10-3mm2/s作為鑒彆良、噁性淚腺上皮性腫瘤的診斷界值，診斷噁性腫瘤的靈敏度為92%，特異度為94%，準確度93%。結論3.0 T DWI可以揭示淚腺上皮性腫瘤的擴散特徵，有助于良、噁性淚腺上皮性腫瘤的鑒彆診斷；通過對ADC值進行定量分析，為淚腺良、噁性上皮性腫瘤的鑒彆診斷提供客觀依據。
목적：평개3.0 T MR확산가권성상(DWI)급표관확산계수(ADC치)대량、악성루선상피성종류적진단개치。재료여방법회고성분석42례경수술병리증실적루선상피성종류상규MRI、DWI영상특점급ADC치，포괄량성종류17례，악성종류25례。소유병례선취b=0、1000 s/mm2 DWI서렬，측량병조확산수한최현저구적ADC치병주통계학분석，량악성종류적ADC치비교채용Mann-Whitney U검험，병회제ADC치진단량악성루선상피성종류적수시자공작특정(ROC)곡선。결과42례종류적평균ADC치위(0.965±0.191)×10-3 mm2/s，량성급악성종류적평균ADC치분별위：(1.142±0.096)×10-3 mm2/s급(0.845±0.140)×10-3 mm2/s，량자지간적ADC치차이구유통계학의의(Z=-4.754，P=0.000<0.01)。악성루선상피성종류적확산수한최현저구ADC치저우량성。ROC곡선하면적S=0.936±0.043, S＞0.9，이용ADC치감별진단종류량、악성적준학도교고。이ADC≤0.968×10-3mm2/s작위감별량、악성루선상피성종류적진단계치，진단악성종류적령민도위92%，특이도위94%，준학도93%。결론3.0 T DWI가이게시루선상피성종류적확산특정，유조우량、악성루선상피성종류적감별진단；통과대ADC치진행정량분석，위루선량、악성상피성종류적감별진단제공객관의거。
Objective: To investigate the diagnostic value of diffusion-weighted imaging (DWI) at 3.0 T MR and apparent diffusion coefifcient (ADC) in distinguishing benign and malignant lacrimal epithelial tumors. Materials and Methods:42 patients with lacrimal epithelial tumor who underwent conventional MRI and diffusion weighted imaging at 3.0 T magnetic resonance system were retrospectively reviewed. All diagnoses were confirmed by surgery and pathologic examination including 17 cases of benign and 25 cases of malignant. The ADC values of 0 and 1000 s/mm2 were measured and analyzed statistically at the region with most significantly restricted diffusion. The ADC value of benign and malignant tumor was compared by Mann-Whitney U test, ROC curve of ADC value for diagnosing benign and malignant tumor was calculated. Results: The average ADC value of whole tumors was (0.965±0.191)×10-3 mm2/s, the average ADC values of benign and malignant tumor were (1.142±0.096)×10-3 mm2/sand (0.845±0.140)×10-3 mm2/s. There was statistical significant differences between the ADC values of benign and malignant tumors (Z=-4.754, P=0.000<0.01). The ADC value of malignant tumors at the region with most signiifcantly restricted diffusion was lower than the ADC value of benign tumors. The acreage under the ROC curve was 0.936±0.043, S>0.9. The accuracy of ROC curve was high. According to ROC curve, using the ADC value of lower than 0.968× 10-3 mm2/s as a threshold for diagnosing malignant lacrimal epithelial tumor, the sensitivity of diagnosis of malignant tumor was 92%, the specificity was 94%, the accuracy was 93%respectively. Conclusions:DWI at 3.0 T MR reveals the different diffusion characteristics of the lacrimal gland epithelial tumors. DWI could provide objective basis through the quantitative analysis of ADC values and be helpful in distinguishing benign and malignant lacrimal epithelial tumors.
