弥散加权成像和半定量、定量动态磁共振增强成像对唾液腺肿瘤的诊断价值。

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Erkan Gökçe, Murat Beyhan
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引用次数: 0

摘要

背景:越来越多地使用功能性磁共振成像(MRI)方法,如弥散加权成像(DWI)和动态对比增强(DCE) MRI,包括序列对比系列,使我们能够获得更多关于肿瘤的微观结构,细胞结构,间质距离和血管分布的信息,这增加了对良性和恶性唾液腺肿瘤(sts)的鉴别能力。在过去的几年里,定量DCE MRI数据包含T1灌注参数(Ktrans, Kep和Ve),被报道有助于sgt良性或恶性亚型的区分。目的:评价DWI及MRI半定量、定量灌注参数对sgt的诊断价值。方法:回顾性分析2017年~ 2021年对67例组织病理诊断的73例肿瘤患者行1.5 T MR弥散MRI[表观弥散系数(ADC)值]、半定量灌注MRI[时间强度曲线(TIC)模式]及定量灌注MRI检查(Ktrans、Kep、Ve)。在ADC值和半定量灌注MRI测量中,不考虑肿瘤的囊性成分,并且通过肿瘤最宽的轴向切片手动放置感兴趣区域(ROI)。TIC型分为4组:A型= Tpeak > 120s;B型=峰值≤120s,冲刷比(WR)≥30%;C型=峰值≤120s, WR < 30%;D型=扁平TIC。在定量灌注MRI分析中,将3D ROI放置在肿瘤最大的实体部分,并自动生成Ktrans, Kep和Ve值。结果:绝大多数sgt位于腮腺(86.3%)。68.5%为良性,31.5%为恶性。多形性腺瘤(PMAs)、沃辛氏瘤(WTs)和恶性肿瘤(MTs)的ADC值差异有统计学意义(P < 0.001)。pma为A型TIC, WTs为B型TIC,绝大多数MTs和其他良性肿瘤(OBTs)(分别为54.5%和45.5%)为C型TIC。pma未出现洗脱,而WTs的平均WR最高(59%±11%)。pma、WTs、OBTs和MTs的Ktrans值无显著差异。pma、WTs的P值与OBTs、MTs的P值差异有统计学意义,WTs的平均Ve值与pma、OBTs、MTs的P值差异有统计学意义(P < 0.001)。结论:定量DCE参数与扩散MRI、半定量增强MRI联合应用可提高sgt的诊断准确性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Diagnostic efficacy of diffusion-weighted imaging and semiquantitative and quantitative dynamic contrast-enhanced magnetic resonance imaging in salivary gland tumors.

Diagnostic efficacy of diffusion-weighted imaging and semiquantitative and quantitative dynamic contrast-enhanced magnetic resonance imaging in salivary gland tumors.

Diagnostic efficacy of diffusion-weighted imaging and semiquantitative and quantitative dynamic contrast-enhanced magnetic resonance imaging in salivary gland tumors.

Diagnostic efficacy of diffusion-weighted imaging and semiquantitative and quantitative dynamic contrast-enhanced magnetic resonance imaging in salivary gland tumors.

Background: Increased use of functional magnetic resonance imaging (MRI) methods such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI consisting of sequential contrast series, allows us to obtain more information on the microstructure, cellularity, interstitial distance, and vascularity of tumors, which has increased the discrimination power for benign and malignant salivary gland tumors (SGTs). In the last few years, quantitative DCE MRI data containing T1 perfusion parameters (Ktrans, Kep and Ve), were reported to contribute to the differentiation of benign or malignant subtypes in SGTs.

Aim: To evaluate the diagnostic efficacy of DWI and semiquantitative and quantitative perfusion MRI parameters in SGTs.

Methods: Diffusion MRI [apparent diffusion coefficient (ADC) value] with a 1.5 T MR machine, semiquantitative perfusion MRI [time intensity curve (TIC) pattern], and quantitative perfusion MRI examinations (Ktrans, Kep and Ve) of 73 tumors in 67 patients with histopathological diagnosis performed from 2017 to 2021 were retrospectively evaluated. In the ADC value and semiquantitative perfusion MRI measurements, cystic components of the tumors were not considered, and the region of interest (ROI) was manually placed through the widest axial section of the tumor. TIC patterns were divided into four groups: Type A = Tpeak > 120 s; type B = Tpeak ≤ 120 s, washout ratio (WR) ≥ 30%; type C = Tpeak ≤ 120 s, WR < 30%; and type D = flat TIC. For the quantitative perfusion MRI analysis, a 3D ROI was placed in the largest solid component of the tumor, and the Ktrans, Kep and Ve values were automatically generated.

Results: The majority of SGTs were located in the parotid glands (86.3%). Of all the SGTs, 68.5% were benign and 31.5% were malignant. Significant differences were found for ADC values among pleomorphic adenomas (PMAs), Warthin's tumors (WTs), and malignant tumors (MTs) (P < 0.001). PMAs had type A and WTs had type B TIC pattern while the vast majority of MTs and other benign tumors (OBTs) (54.5% and 45.5%, respectively) displayed type C TIC pattern. PMAs showed no washout, while the highest mean WR was observed in WTs (59% ± 11%). Ktrans values of PMAs, WTs, OBTs, and MTs were not significantly different. Kep values of PMAs and WTs were significantly different from those of OBTs and MTs. Mean Ve value of WTs was significantly different from those of PMAs, OBTs, and MTs (P < 0.001).

Conclusion: The use of quantitative DCE parameters along with diffusion MRI and semiquantitative contrast-enhanced MRI in SGTs could improve the diagnostic accuracy.

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来源期刊
World journal of radiology
World journal of radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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