摘要
目的:探讨常规MRI平扫信号强度比值(SIR)在腮腺Warthin瘤(WT)和多形性腺瘤(PA)鉴别诊断中的价值。方法:回顾分析经手术病理证实的46例58枚WT和53例53枚PA的MRI资料,测量T_(1)WI和T_(2)WI序列瘤体、脊髓、桥脑的信号强度均值,计算T_(1)WI瘤体/脊髓(T_(1)-sSIR)、T_(1)WI瘤体/桥脑(T_(1)-pSIR)、T_(2)WI瘤体/脊髓(T_(2)-sSIR)、T_(2)WI瘤体/桥脑(T_(2)-pSIR)值;采用t检验分析四个比值在两组中的差异,并通过受试者工作特异度曲线(ROC)获得鉴别WT与PA的最佳阈值,再分别比较T_(1)WI、T_(2)WI和T_(1)WI联合T_(2)WI的SIR对鉴别两者的诊断效能。通过ICC分析两位观测者测量间的差异。结果:58枚WT和53枚PA中,T_(1)-sSIR、T_(1)-pSIR、T_(2)-sSIR、T_(2)-pSIR鉴别WT和PA均具有显著差异(t=-10.280~7.532,P均<0.001)。T_(1)-sSIR和T_(2)-s SIR鉴别二者的AUC分别为0.912和0.931,当阈值分别为1.07和1.24时,敏感度和特异度分别为87.9%和84.9%、93.1%和83.0%,二者联合的AUC为0.979,敏感度和特异度为94.8%和96.2%。T_(1)-pSIR和T_(2)-pSIR鉴别二者的AUC分别为0.908和0.927,当阈值分别为1.08和1.25时,敏感度和特异度分别为81.0%和90.6%、89.7%和84.9%,二者联合的AUC为0.979,敏感度和特异度为93.1%和98.1%。两位观测者间具有很好的一致性(ICC值范围为0.841~0.969)。结论:选用脊髓和桥脑作为参照物的常规MRI平扫信号强度比值均具有重要价值,且T_(1)WI和T_(2)WI联合可明显提高诊断效能。
Objective:To investigate the differential value of conventional MRI signal intensity ratio(SIR)in parotid Warthin’s tumor(WT)and pleomorphic adenoma(PA).Methods:This study included 46 cases with 58 WT and 53 cases with53 PA,which was confirmed by surgery and pathology.The MRI data of patients were analyzed retrospectively.The mean sig-nal intensity of tumor,spinal cord,and pons on T_(1)WI and T_(2)WI sequences were measured.The following data were calculated,including tumor to spinal cord signal intensity ratio on T_(1)WI(T_(1)-sSIR),tumor to pons signal intensity ratio on T_(1)WI(T_(1)-pSIR),tumor to spinal cord signal intensity ratio on T_(2)WI(T_(2)-sSIR),and tumor to pons signal intensity ratio on T_(2)WI(T_(2)-pSIR).The differences of the four SIRs between the two groups were analyzed using the t-test.The optimal threshold for distinguishing WT and PA was analyzed by the receiver operating characteristic(ROC)curve,and then the diagnostic efficacies of SIRs on T_(1)WI,T_(2)WI,and T_(1)WI combined with T_(2)WI for differentiating the two diseases were compared,respectively.Interclass correlation coefficient(ICC)was used to analyze the differences between the two observers’measurements.Results:There were significant differences of T_(1)-sSIR,T_(1)-pSIR,T_(2)-sSIR,and T_(2)-pSIR between WT and PA(t=-10.280~7.532,all P<0.01).The area under the curve(AUC)of T_(1)-sSIR and T_(2)-sSIR for differentiating WT and PA were 0.912 and 0.931,respectively.When the thresholds were 1.07 and 1.24,the sensitivity and specificity were 87.9%and 84.9%,93.1%and 83.0%,respectively.The combined AUC of T_(1)-sSIR and T_(2)-sSIR was 0.979,and the sensitivity and specificity were 94.8%and 96.2%.The AUC of T_(1)-pSIR and T_(2)-pSIR for differentiating WT and PA were 0.908 and 0.927,respectively.When the thresholds were 1.08 and1.25,the sensitivity and specificity were 81.0%and 90.6%,89.7%and 84.9%,respectively.The combined AUC of T_(1)-pSIR and T_(2)-pSIR was 0.979,and the sensitivity and specificity were 93.1%and 98.1%.The two observers demonstrated good a-greement on T_(1)-sSIR,T_(1)-pSIR,T_(2)-sSIR,and T_(2)-pSIR(ICC value,0.841~0.969).Conclusion:The conventional MRI SIRs using the spinal cord and the pons as references are of great value in differentiating WT and PA.The combination of T_(1)WI and T_(2)WI can significantly improve diagnostic performance.
作者
胡春锋
魏培英
舒艳艳
韩志江
HU Chun-feng;WEI Pei-ying;SHU Yan-yan;HAN Zhi-jiang(The Fourth Clinical Medical College of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310053,China;Affiliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China;Xiaoshan District First People’s Hospital of Hangzhou,Hangzhou 311200,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2022年第11期771-774,778,共5页
Journal of China Clinic Medical Imaging
基金
浙江省医药卫生科技计划项目(2020RC091)
浙江省医药卫生科技计划项目(2021RC024)
关键词
腺淋巴瘤
腺瘤
多形性
磁共振成像
Adenolymphoma
Adenoma,Pleomorphic
Magnetic Resonance Imaging
作者简介
胡春锋(1998-),女,浙江杭州人,住院医师。E-mail:hcf0609@163.com;通信作者:韩志江,浙江大学医学院附属杭州市第一人民医院放射科,310006。E-mail:hzj1022@zju.edu.cn
