CAJ | 학술논문

目的：探讨眼眶良恶性肿块在不同 b 值磁共振扩散加权成像(DWI)中表观扩散系数(ADC)值的变化,评价 ADC 值在眼眶良恶性肿块诊断中的价值。方法81例眼眶肿块患者,其中良性肿块55例,恶性肿块26例。术前行常规 MRI 及 DWI 检查,每次取2个扩散敏感因子即 b 值=0 s/mm2和/或400、700、1000 s/mm2,观察和比较不同 b 值条件下良恶性肿块的 ADC 值差异,采用 ROC 曲线评价 ADC 值的诊断价值。结果3组 b 值下,眼眶良性肿块 ADC 值分别为(1.56±0.35)×10-3 mm2/s、(1.40±0.34)×10-3 mm2/s、(1.30±0.32)×10-3 mm2/s,差异有统计学意义(P <0.01)。恶性肿块 ADC 值分别为(1.12±0.47)×10-3 mm2/s、(0.92±0.42)×10-3 mm2/s、(0.87±0.40)×10-3 mm2/s,差异无统计学意义(P =0.093)。3组 b 值的 ADC 值诊断眼眶良恶性肿块的 ROC 曲线下面积分别为0.799、0.866、0.867；诊断良恶性肿块的阈值分别为1.05×10-3 mm2/s、0.94×10-3 mm2/s 和0.93×10-3 mm2/s,判断眼眶恶性肿块的灵敏度分别为65%、81%、81%,特异度分别为94.5%、91%、85%,阳性预测值分别为85%、80%、72%,阴性预测值分别为85%、91%、90%,正确率分别为85%、87%、84%。结论b 值为700 s/mm2诊断效能较高,DWI ADC 值对眼眶良恶性肿块具有辅助诊断价值,可以反映眼眶肿块的扩散特征。
목적：탐토안광량악성종괴재불동 b 치자공진확산가권성상(DWI)중표관확산계수(ADC)치적변화,평개 ADC 치재안광량악성종괴진단중적개치。방법81례안광종괴환자,기중량성종괴55례,악성종괴26례。술전행상규 MRI 급 DWI 검사,매차취2개확산민감인자즉 b 치=0 s/mm2화/혹400、700、1000 s/mm2,관찰화비교불동 b 치조건하량악성종괴적 ADC 치차이,채용 ROC 곡선평개 ADC 치적진단개치。결과3조 b 치하,안광량성종괴 ADC 치분별위(1.56±0.35)×10-3 mm2/s、(1.40±0.34)×10-3 mm2/s、(1.30±0.32)×10-3 mm2/s,차이유통계학의의(P <0.01)。악성종괴 ADC 치분별위(1.12±0.47)×10-3 mm2/s、(0.92±0.42)×10-3 mm2/s、(0.87±0.40)×10-3 mm2/s,차이무통계학의의(P =0.093)。3조 b 치적 ADC 치진단안광량악성종괴적 ROC 곡선하면적분별위0.799、0.866、0.867；진단량악성종괴적역치분별위1.05×10-3 mm2/s、0.94×10-3 mm2/s 화0.93×10-3 mm2/s,판단안광악성종괴적령민도분별위65%、81%、81%,특이도분별위94.5%、91%、85%,양성예측치분별위85%、80%、72%,음성예측치분별위85%、91%、90%,정학솔분별위85%、87%、84%。결론b 치위700 s/mm2진단효능교고,DWI ADC 치대안광량악성종괴구유보조진단개치,가이반영안광종괴적확산특정。
Objective To investigate the changes on apparent diffusion coefficient(ADC)of diffusion weighted imaging with dif-ferent b values and to assess the diagnostic value of ADC for discriminating malignant from benign orbital masses.Methods 81 pa-tients (55 benign orbital masses and 26 malignant orbital masses)were enrolled.These patients underwent serial MR and echo-pla-nar DW imaging examinations of the orbits with b values=0 and/or 400,700,1 000 s/mm2 .The differences of ADC values under different b values between benign and malignant orbital masses were observed and compared,and diagnosis of ADC values was as-sessed by the receiver operating characteristic (ROC)curve.Results In three groups,the ADC values of benign orbital masses [(1.56±0.35)×10 -3 mm2/s,(1.40±0.34)×10 -3 mm2/s and (1.30±0.32)×10 -3 mm2/s,respectively]were significantly differ-ent (P <0.01),while the ADC values of malignant orbital masses were not statistically different (P =0.093)[(1.12 ±0.47)× 10 -3 mm2/s,(0.92±0.42)×10 -3 mm2/s and (0.87±0.40)× 10 -3 mm2/s,respectively].The areas under the ROC curve of ADC values were 0.799,0.866 and 0.867,respectively.The threshold values were 1.05 × 10 -3 mm2/s,0.94 × 10 -3 mm2/s and 0.93 × 10 -3 mm2/s (while sensitivity were 65%,81% and 81%;specificity were 94.5%,91% and 85%;positive predictive values were 85%,80%,72%,negative predictive values were 85%,91%,90%,and accuracy were 85%,87% and 84%,respectively).Conclusion The b value of 700 s/mm2 offered better diagnostic performance.ADC values of diffusion weighted imaging can reflect diffusion characteristics of the orbital masses,as a complementary tool in the differentiation of malignant from benign orbital masses.