Role of resolve DWI and DCE MRI in differentiating benign and malignant skull base lesions.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-09-01 Epub Date: 2025-09-19 DOI:10.1007/s00234-025-03760-5

Pradeep Mohanasundaram, Jyoti Kumar, Gaurav Shanker Pradhan, Daljit Singh, Ishwar Singh

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引用次数: 0

Abstract

Purpose: To assess the utility of RESOLVE Diffusion-Weighted Imaging (DWI) and Dynamic Contrast-Enhanced (DCE) MRI in differentiating benign and malignant skull base lesions using qualitative and quantitative imaging parameters.

Methods: This prospective study included 44 patients with 45 skull base lesions who underwent MRI with RESOLVE DWI and DCE-MRI. Apparent diffusion coefficient (ADC) values and lesion-to-medulla ADC ratios were calculated from DWI. Perfusion parameters (Ktrans, Kep, Ve) and time-intensity curve (TIC) were derived from DCE-MRI. Benign and malignant lesions were statistically compared, and receiver operating characteristic analysis was performed to evaluate diagnostic capability.

Results: Malignant lesions had significantly lower mean ADC values (0.88 × 10⁻³ mm²/s) than benign lesions (1.05 × 10⁻³ mm²/s, p = 0.033). The lesion-to-medulla ADC ratio was also significantly lower in malignant lesions (1.03 vs. 1.25, p = 0.029), yielding 89% sensitivity and 44% specificity at a cutoff ≤ 1.167 (AUC = 0.695). Among DCE-MRI parameters, both Kep and the distribution of time-intensity curve (TIC) showed significant differences between benign and malignant lesions (p = 0.037 and p < 0.001, respectively). Kep was higher in malignant lesions (0.98 vs. 0.78), with an AUC of 0.689, 94% sensitivity, and 52% specificity at a cutoff of ≥ 0.581. Ktrans and Ve did not show significant statistical difference.

Conclusion: RESOLVE DWI and DCE-MRI are effective non-invasive tools for differentiating benign and malignant skull base lesions. The ADC ratio and Kep are valuable quantitative markers, while TIC pattern analysis offers complementary qualitative insights, enhancing diagnostic confidence.

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分辨率DWI和DCE MRI在鉴别颅底良恶性病变中的作用。

目的：评估RESOLVE弥散加权成像（DWI）和动态对比增强（DCE） MRI在定性和定量成像参数鉴别颅底良恶性病变中的应用价值。方法：这项前瞻性研究包括44例45个颅底病变的患者，他们接受了RESOLVE DWI和DCE-MRI的MRI检查。DWI计算表观扩散系数（ADC）值和病变与髓质的ADC比。灌注参数（Ktrans, Kep, Ve）和时间-强度曲线（TIC）均由DCE-MRI获得。对良、恶性病变进行统计学比较，并对受者操作特征进行分析，评价诊断能力。结果：恶性病变的平均ADC值（0.88 × 10⁻³mm²/s）明显低于良性病变（1.05 × 10⁻³mm²/s, p = 0.033）。病变与髓质的ADC比在恶性病变中也显著降低（1.03 vs. 1.25, p = 0.029），在截断值≤1.167 （AUC = 0.695）时，敏感性为89%，特异性为44%。在DCE-MRI参数中，Kep及时间-强度曲线（TIC）分布在良、恶性病变间差异均有统计学意义（p = 0.037, p = 0.037）。结论：RESOLVE DWI与DCE-MRI是鉴别颅底良、恶性病变的有效无创工具。ADC比率和Kep是有价值的定量标记，而TIC模式分析提供了互补的定性见解，提高了诊断的信心。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.