Characterization of soft tissue masses: can quantitative diffusion weighted imaging reliably distinguish cysts from solid masses?
Characterization of soft tissue masses: can quantitative diffusion weighted imaging reliably distinguish cysts from solid masses?
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DOI：
10.1007/s00256-013-1703-7
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发表时间：
2013-11-01
影响因子：
2.1
通讯作者：
Fayad, Laura M.
中科院分区：
文献类型：
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作者：
Subhawong, Ty K.;Durand, Daniel J.;Fayad, Laura M.
为探讨定量弥散加权成像（DWI）结合表观弥散系数（ADC）标测对软组织肿块（STM）定性为囊肿或实性肿块的准确性，本回顾性研究经IRB批准，纳入36例受试者的37个STM，均经常规MRI成像（T1加权、T2加权、增强T1加权序列）和DWI（b值50、400、800 s/mm（2））与ADC标测。STM被定义为组织学或临床随访的非实体囊肿，以及组织学的实体囊肿。对于每个STM，由两名观察员记录ADC值（范围，平均值）。采用Wilcoxon秩和法和受试者工作特征（ROC）分析比较囊肿和实性STM ADC值的差异，囊肿ADC值的最小值（1.65 vs 0.68，p = 0.003）和平均值（2.31 vs 1.45，p = 0.005）均高于实性STM。最小和平均ADC值的ROC下面积分别为0.82和0.81。以ADC值1.8（最小值）或2.5（平均值）为阈值，诊断STM为囊肿的敏感性分别为60%和80%，特异性为100%;对于具有高液体信号强度的肿瘤，这些阈值的性能得到保持。弥散加权成像与ADC映射提供了一个非-对比MRI可替代用于将STM表征为囊肿或实性肿块。存在阈值ADC值，其提供100%的特异性来区分囊肿和实性STM，甚至对于T2加权图像上的高液体信号强度的肿瘤。
To investigate the accuracy of quantitative diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping for characterizing soft tissue masses (STMs) as cysts or solid masses.This IRB-approved retrospective study included 36 subjects with 37 STMs imaged by conventional MRI (T1-weighted, T2-weighted, contrast-enhanced T1-weighted sequences) and DWI (b-values 50, 400, 800 s/mm(2)) with ADC mapping. STMs were defined as non-solid cysts by histology or clinical follow-up, and as solid by histology. For each STM, ADC values (range, mean) were recorded by two observers. Differences between ADC values in cysts and solid STMs were compared using Wilcoxon rank-sum and receiver-operating characteristic (ROC) analysis.There were higher minimum (1.65 vs 0.68, p = 0.003) and mean (2.31 vs 1.45, p = 0.005) ADC values in cysts than solid STMs respectively. Areas under the ROC for minimum and mean ADC values were 0.82 and 0.81 respectively. Using threshold ADC values of 1.8 (minimum) or 2.5 (mean) yielded a sensitivity of 60 % and 80 % respectively, and a specificity of 100 % for classifying a STM as a cyst; for tumors with high fluid-signal intensity, the performance of these threshold values was maintained.Diffusion-weighted imaging with ADC mapping provides a non-contrast MRI alternative for the characterization of STMs as cysts or solid masses. Threshold ADC values exist that provide 100 % specificity for differentiating cysts and solid STMs, even for tumors of high fluid-signal intensity on T2-weighted images.