Characterization of parotid gland tumors: added value of permeability MR imaging to DWI and DCE-MRI
Characterization of parotid gland tumors: added value of permeability MR imaging to DWI and DCE-MRI
复制标题
DOI：
10.1007/s00330-020-07004-3
复制
发表时间：
2020-07-01
影响因子：
5.9
通讯作者：
Yamamoto, Hidetaka
中科院分区：
文献类型：
--
作者：
Yabuuchi, Hidetake;Kamitani, Takeshi;Yamamoto, Hidetaka
目的探讨通透性MRI对腮腺肿瘤T2WI、时间-强度曲线半定量分析、体素内非相干运动弥散加权成像（IVIM-DWI）的附加价值。方法本回顾性研究经机构审查委员会批准，放弃知情同意。对61例腮腺肿瘤患者进行T2WI、IVIM-DWI及通透性MRI检查。TIC类型分为持续性、洗脱期和平稳期。测量T2WI上病灶与肌肉的信号强度比、表观扩散系数（adc）、IVIM-DWI上的dandf值，以及通透性MRI上的k（trans）、k（ep）、V-e和v (p)值。通过多次比较来确定4种组织病理类型（多形性腺瘤、Warthin肿瘤、其他良性肿瘤和恶性肿瘤）之间是否存在差异。比较了渗透率MRI修改诊断前后的诊断准确率。在一项验证性研究中，对60例患者的60例腮腺肿瘤进行了检查。结果恶性肿瘤的ADC和dvalue均显著低于除Warthin肿瘤外的良性肿瘤，但高于Warthin肿瘤。Warthin肿瘤的k（ep）和v (p)值明显高于恶性肿瘤。多因素分析表明，TIC型、D和k（ep）值是适宜的参数。McNemar试验显示，添加k（ep）显著增加敏感性（11/ 12,92%）和特异性（46/ 49,94%）。验证研究获得高灵敏度（14/16,88%）和特异性（41/44,93%）。结论渗透性MRI对腮腺肿瘤的诊断有较好的参考价值，可与IVIM-MRI和DCE-MRI的半定量TIC分析相比较
Objectives To determine added value of permeability MRI in parotid tumor characterization to T2-weighted imaging (T2WI), semi-quantitative analysis of time-intensity curve (TIC), and intra-voxel incoherent motion diffusion-weighted imaging (IVIM-DWI). Methods This retrospective study was approved by the institutional review board, and the informed consent was waived. Sixty-one parotid tumors in 61 patients were examined using T2WI, IVIM-DWI, and permeability MRI. TIC patterns were categorized as persistent, washout, or plateau. Signal intensity ratio of lesion-to-muscle on T2WI, apparent diffusion coefficients (ADCs),Dandfvalues from IVIM-DWI, andK(trans),k(ep),V-e, andV(p)values from permeability MRI were measured. Multiple comparisons were applied to determine whether any differences among 4 histopathologic types (pleomorphic adenomas, Warthin's tumors, other benign tumors, and malignant tumors) existed. Diagnostic accuracy was compared before and after modification diagnosis referring to permeability MRI. In a validation study, 60 parotid tumors in 60 patients were examined. Results ADC andDvalues of malignant tumors were significantly lower than those of benign tumors other than Warthin's tumors, but higher than those of Warthin's tumors.k(ep)andV(p)values of Warthin's tumors were significantly higher than those of malignant tumors. Multivariate analyses showed that TIC pattern,D, andk(ep)values were suitable parameters. McNemar's test showed a significant increase of sensitivity (11/12, 92%) and specificity (46/49, 94%) with addingk(ep). The validation study yielded high sensitivity (14/16, 88%) and specificity (41/44, 93%). Conclusion Permeability MRI offers added value to IVIM-MRI and semi-quantitative TIC analysis of DCE-MRI in characterization of parotid tumors