CAJ | 학술논문

目的：评价扩散加权成像(DWI)和表观扩散系数(ADC)值测量在诊断及鉴别诊断舌良恶性病变中的价值。方法对75例舌部病变患者于治疗前行常规 MRI 平扫、增强和 DWI 检查,其中舌良性病变32例,恶性肿瘤43例。b 值为0、1000 s/mm2,测量病变的 ADC 均值,进行 t 检验统计处理和分析,运用 ROC 曲线评价 ADC 值的诊断价值。结果良性病变 ADC 值为(1.84±0.47)×10-3 mm2/s,恶性肿瘤 ADC 值为(1.12±0.21)×10-3 mm2/s,恶性肿瘤 ADC 值明显低于良性病变(t 值为-8.038,P 值<0.000)。ADC 值诊断舌部良恶性病变的 ROC 曲线下面积为0.957±0.022,ADC 值以1.30×10-3 mm2/s 为阈值时,以病理结果为对照,诊断舌恶性肿瘤的灵敏度为90.7%,特异度为93.8%,准确度为92%,与病理结果行一致性检验,Kappa 值为0.813。结论舌良恶性病变具有不同的扩散特征,ADC 值对于两者之间的鉴别诊断具有辅助诊断价值。
목적：평개확산가권성상(DWI)화표관확산계수(ADC)치측량재진단급감별진단설량악성병변중적개치。방법대75례설부병변환자우치료전행상규 MRI 평소、증강화 DWI 검사,기중설량성병변32례,악성종류43례。b 치위0、1000 s/mm2,측량병변적 ADC 균치,진행 t 검험통계처리화분석,운용 ROC 곡선평개 ADC 치적진단개치。결과량성병변 ADC 치위(1.84±0.47)×10-3 mm2/s,악성종류 ADC 치위(1.12±0.21)×10-3 mm2/s,악성종류 ADC 치명현저우량성병변(t 치위-8.038,P 치<0.000)。ADC 치진단설부량악성병변적 ROC 곡선하면적위0.957±0.022,ADC 치이1.30×10-3 mm2/s 위역치시,이병리결과위대조,진단설악성종류적령민도위90.7%,특이도위93.8%,준학도위92%,여병리결과행일치성검험,Kappa 치위0.813。결론설량악성병변구유불동적확산특정,ADC 치대우량자지간적감별진단구유보조진단개치。
Objective To observe the value of diffusion-weighted imaging (DWI)and ADC value in the differential diagnosis of benign and malignant lesions of the tongue.Methods 75 patients with lingual lesions,including 32 benign lesions and 43 malignant tumors,underwent conventional MRI,contrast-enhanced MRI and DWI with b values of 0 and 1 000 s/mm2 before therapy.ADC maps were reconstructed,and the ADC values of the lingual lesions were calculated.Diagnostic performance of ADC was compared using receiver operating characteristic curves (ROC).Results The mean ADC values of benign lesions and malignant tumors were (1.84±0.47)×10 -3 mm2/s and (1.12±0.21)×10 -3 mm2/s,respectively.Malignant tumors had lower ADCs than benign lesions (t=-8.038,P <0.000).The areas under the ROC curves of ADC diagnosing benign and malignant lesions of the tongue was 0.957±0.022.The optimal cutoff values of ADC for differentiating benign and malignant lesions of the tongue was 1.30 × 10 -3 mm2/s with sensitivity of 90.7%,specificity of 93.8% and accuracy of 92%.And ADC had a high consistency compared with pathological results (Kappa values were 0.813).Conclusion Different features between benign and malignant lesions of the tongue are able to be identified with DWI,which can be applied as a complementary tool in the detection of benign and malignant lesions of the tongue.