中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2014年
3期
207-210
,共4页
王永哲%杨本涛%鲜军舫%李静%陈光利
王永哲%楊本濤%鮮軍舫%李靜%陳光利
왕영철%양본도%선군방%리정%진광리
鼻肿瘤%磁共振成像,弥散%对比研究
鼻腫瘤%磁共振成像,瀰散%對比研究
비종류%자공진성상,미산%대비연구
Nose neoplasms%Diffusion magnetic resonance imaging%Comparative study
目的 探讨ADC值对鼻腔鼻窦实性肿块良恶性的鉴别诊断价值.方法 回顾性分析经临床手术病理证实,肿块为实性且直径＞1 cm的67例鼻腔鼻窦肿块患者资料,均行MR DWI检查,测量病变实性部分ROI内的ADC值.根据手术病理结果将67个患者分为良性组和恶性组,再根据肿块病理类型进一步分为淋巴造血系统肿块、恶性上皮及间叶组织肿块、良性上皮及间叶组织肿块及血管源性肿块4组.采用t检验及单因素方差分析分别比较良、恶性及不同病理类型病变ADC值之间的差异；以鼻腔鼻窦不同肿块的ADC值作为临界点绘制出ROC曲线,计算曲线下面积(Az),确定诊断阈值,评价其诊断效能.结果 67例患者肿瘤均为单发,恶性肿块22个,其中淋巴造血系统肿瘤6个、上皮及间叶组织来源恶性肿瘤16个；良性肿块45个,其中上皮及间叶组织来源良性肿瘤22个、血管源性病变23个.恶性肿块和良性肿块的ADC值分别为(0.88 ±0.26)×10-3和(1.54±0.41) ×10-3 mm2/s,差异有统计学意义(t值=6.897,P值＜0.01).淋巴造血系统肿块、恶性上皮及间叶组织肿块、良性上皮及间叶组织肿块和血管源性肿块的ADC值分别为(0.63±0.10) ×10-3、(0.97±0.24) ×10-3、(1.38±0.23)×10-3和(1.68 ±0.49)×10-3mm2/s,差异有统计学意义(F=22.788,P＜0.01),组内两两比较差异也均有统计学意义(P值＜0.05).以鼻腔鼻窦不同肿块的ADC值作为临界点判断其良恶性并绘制ROC,曲线下面积为0.945.以ADC=1.08×10-3 mm2/s作为诊断阈值,诊断恶性肿瘤的敏感度为81.8％(18/22),特异度为97.8％ (44/45),准确度为92.5％(62/67).结论 ADC值对鼻腔鼻窦良、恶性及不同病理类型病变的鉴别诊断具有一定的参考价值.
目的 探討ADC值對鼻腔鼻竇實性腫塊良噁性的鑒彆診斷價值.方法 迴顧性分析經臨床手術病理證實,腫塊為實性且直徑＞1 cm的67例鼻腔鼻竇腫塊患者資料,均行MR DWI檢查,測量病變實性部分ROI內的ADC值.根據手術病理結果將67箇患者分為良性組和噁性組,再根據腫塊病理類型進一步分為淋巴造血繫統腫塊、噁性上皮及間葉組織腫塊、良性上皮及間葉組織腫塊及血管源性腫塊4組.採用t檢驗及單因素方差分析分彆比較良、噁性及不同病理類型病變ADC值之間的差異；以鼻腔鼻竇不同腫塊的ADC值作為臨界點繪製齣ROC麯線,計算麯線下麵積(Az),確定診斷閾值,評價其診斷效能.結果 67例患者腫瘤均為單髮,噁性腫塊22箇,其中淋巴造血繫統腫瘤6箇、上皮及間葉組織來源噁性腫瘤16箇；良性腫塊45箇,其中上皮及間葉組織來源良性腫瘤22箇、血管源性病變23箇.噁性腫塊和良性腫塊的ADC值分彆為(0.88 ±0.26)×10-3和(1.54±0.41) ×10-3 mm2/s,差異有統計學意義(t值=6.897,P值＜0.01).淋巴造血繫統腫塊、噁性上皮及間葉組織腫塊、良性上皮及間葉組織腫塊和血管源性腫塊的ADC值分彆為(0.63±0.10) ×10-3、(0.97±0.24) ×10-3、(1.38±0.23)×10-3和(1.68 ±0.49)×10-3mm2/s,差異有統計學意義(F=22.788,P＜0.01),組內兩兩比較差異也均有統計學意義(P值＜0.05).以鼻腔鼻竇不同腫塊的ADC值作為臨界點判斷其良噁性併繪製ROC,麯線下麵積為0.945.以ADC=1.08×10-3 mm2/s作為診斷閾值,診斷噁性腫瘤的敏感度為81.8％(18/22),特異度為97.8％ (44/45),準確度為92.5％(62/67).結論 ADC值對鼻腔鼻竇良、噁性及不同病理類型病變的鑒彆診斷具有一定的參攷價值.
목적 탐토ADC치대비강비두실성종괴량악성적감별진단개치.방법 회고성분석경림상수술병리증실,종괴위실성차직경＞1 cm적67례비강비두종괴환자자료,균행MR DWI검사,측량병변실성부분ROI내적ADC치.근거수술병리결과장67개환자분위량성조화악성조,재근거종괴병리류형진일보분위림파조혈계통종괴、악성상피급간협조직종괴、량성상피급간협조직종괴급혈관원성종괴4조.채용t검험급단인소방차분석분별비교량、악성급불동병리류형병변ADC치지간적차이；이비강비두불동종괴적ADC치작위림계점회제출ROC곡선,계산곡선하면적(Az),학정진단역치,평개기진단효능.결과 67례환자종류균위단발,악성종괴22개,기중림파조혈계통종류6개、상피급간협조직래원악성종류16개；량성종괴45개,기중상피급간협조직래원량성종류22개、혈관원성병변23개.악성종괴화량성종괴적ADC치분별위(0.88 ±0.26)×10-3화(1.54±0.41) ×10-3 mm2/s,차이유통계학의의(t치=6.897,P치＜0.01).림파조혈계통종괴、악성상피급간협조직종괴、량성상피급간협조직종괴화혈관원성종괴적ADC치분별위(0.63±0.10) ×10-3、(0.97±0.24) ×10-3、(1.38±0.23)×10-3화(1.68 ±0.49)×10-3mm2/s,차이유통계학의의(F=22.788,P＜0.01),조내량량비교차이야균유통계학의의(P치＜0.05).이비강비두불동종괴적ADC치작위림계점판단기량악성병회제ROC,곡선하면적위0.945.이ADC=1.08×10-3 mm2/s작위진단역치,진단악성종류적민감도위81.8％(18/22),특이도위97.8％ (44/45),준학도위92.5％(62/67).결론 ADC치대비강비두량、악성급불동병리류형병변적감별진단구유일정적삼고개치.
Objective To investigate the diagnostic value of apparent diffusion coefficient in the evaluation of sinonasal masses.Methods Sixty-seven sinonasal solid masses over 1 cm in diameter confirmed by pathology were retrospectively analyzed,all patients underwent preoperative routine MRI with DWI,the ADC values were measured in ROI within the solid mass.The patients were divided into benign and malignant groups by the histopathology,according to pathological findings,the patients were further divided into the hematolymphoid tumors,the malignancy of epithelium and mesenchymal tissue,the benign tumors of epithelial and mesenchymal tissue,and vasogenic masses.ANOVA test and t test were used to compare the ADC values of different groups.The receiver operating characteristic curve (ROC) was constructed using various cut points of ADC for different parameters to confirm the diagnostic threshold value and evaluate the diagnostic efficacy.Results All lesions were solitary.There were 22 malignant tumors,of which 6 lesions were hematolymphoid tumors and 16 lesions malignancy from epithelium and mesenchymal tissue.There were 45 benign tumors,of which 22 lesions were benign tumors from epithelium and mesenchymal tissue and 23 lesions vasogenic masses.The mean ADC value of malignant and benign masses was(0.88 ± 0.26) × 10-3 mm2/s and (1.54 ± 0.41) × 10-3 mm2/s respectively.There was statistically significant differences between them (t =6.897,P ＜ 0.01).The mean ADC value was(0.63 ± 0.10) × 10-3 mm2/s in hematolymphoid tumors,(0.97 ±0.24) × 10 3 mm2/s in malignancy from epithelium and mesenchymal tissue,(1.38 ± 0.23) × 10-3 mm2/s in benign tumors from epithelium and mesenchymal tissue,(1.68 ± 0.49) × 10-3 mm2/s in vasogenic masses respectively.There was statistically significant difference among all 4 groups(F =22.788,P ＜ 0.01),and the differences between any 2 groups were still statistically significant(P ＜ 0.05).The area under the ROC calculated was 0.945.Using an ADC value of 1.08 × 10-3 mm2/s as the threshold value for differentiating malignant from benign lesions,the best result obtained had a sensitivity of 81.8％ (18/22),specificity of 97.8％ (44/45),accuracy of 92.5 ％ (62/67).Conclusion The ADC value is a valuable tool in differentiating benign from malignant masses and different kinds of masses in sinus and nasal cavity.
