Habermann C R, Gossrau P, Graessner J, Arndt C, Cramer M C, Reitmeier F, Jaehne M, Adam G
Department of Diagnostic and Interventional Radiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Rofo. 2005 Jul;177(7):940-5. doi: 10.1055/s-2005-858297.
PURPOSE: To investigate the feasibility of using diffusion-weighted (DW) echo-planar imaging (EPI) for differentiating primary parotid gland tumors. MATERIAL AND METHODS: Fifty consecutive patients with a suspected primary tumor of the parotid gland were examined with a DW EPI sequence (TR 1,500 msec, TE 77 msec, field of view 250 x 250 mm, pixel size 2.10 x 1.95 mm, section thickness 5 mm). The b factors used were 0, 500, and 1,000 sec/mm (2). Apparent diffusion coefficient (ADC) maps were digitally transferred to MRIcro (Chris Rorden, University of Nottingham, Great Britain) and evaluated with a manually placed irregular region of interest (ROI) containing the entire tumor. Additionally, the contralateral, non affected parotid gland was measured and a circular ROI containing 100 - 200 pixels was placed in the cerebrospinal fluid (CSF) next to the spinal cord in every patient. For comparison of the results, the two-tailed Student's t test was used, based on the median ADC values for each patient, and a p-value <.05 was determined to indicate statistical significance. RESULTS: In 45 patients, a primary neoplasm of the parotid gland could be histologically verified. For the non-affected parotid glands of all 45 evaluated patients, the mean ADC value was 1.14 x 10 ( - 3) mm (2)/sec +/- 0.12 x 10 ( - 3) mm (2)/sec (mean +/- standard deviation). Seven different entities of parotid gland tumors were histologically discriminated. Pleomorphic adenomas (2.14 x 10 ( - 3) mm (2)/sec +/- 0.11 x 10 ( - 3) mm (2)/sec), Warthin tumors (0.85 x 10 ( - 3) mm (2)/sec +/- 0.1 x 10 ( - 3) mm (2)/sec), and mucoepidermoid carcinomas (1.04 x 10 ( - 3) mm (2)/sec +/- 0.3 x 10 ( - 3) mm (2)/sec) showed statistically significant different ADC values in comparison to all other evaluated tumors (p .001), and also among each other (p <.001). Additionally, ADC values presented by lipomas were statistically significant compared to all other entities (p <.001 to .015). Among all other [corrected] primary malignant parotid gland tumors, no statistically significant ADC values could be observed (p .18 to 1). CONCLUSION: Diffusion-weighted echo-planar MRI seems to be a valuable tool for differentiating benign from malignant primary parotid gland tumors.
目的：探讨使用扩散加权（DW）回波平面成像（EPI）鉴别腮腺原发性肿瘤的可行性。 材料与方法：连续50例疑似腮腺原发性肿瘤患者接受DW EPI序列检查（重复时间1500毫秒，回波时间77毫秒，视野250×250毫米，像素大小2.10×1.95毫米，层厚5毫米）。使用的b值为0、500和1000秒/毫米²。表观扩散系数（ADC）图被数字传输至MRIcro（英国诺丁汉大学的Chris Rorden），并通过手动放置包含整个肿瘤的不规则感兴趣区（ROI）进行评估。此外，测量对侧未受影响的腮腺，并在每位患者脊髓旁的脑脊液（CSF）中放置一个包含100 - 200像素的圆形ROI。为比较结果，基于每位患者的ADC中位数，使用双尾Student t检验，p值<.05被判定为具有统计学意义。 结果：45例患者的腮腺原发性肿瘤经组织学证实。在所有45例接受评估患者的未受影响腮腺中，平均ADC值为1.14×10⁻³毫米²/秒±0.12×10⁻³毫米²/秒（平均值±标准差）。组织学上鉴别出7种不同类型的腮腺肿瘤。多形性腺瘤（2.14×10⁻³毫米²/秒±0.11×10⁻³毫米²/秒）、沃辛瘤（0.85×10⁻³毫米²/秒±0.1×10⁻³毫米²/秒）和黏液表皮样癌（1.04×10⁻³毫米²/秒±0.3×10⁻³毫米²/秒）与所有其他评估肿瘤相比，ADC值具有统计学显著差异（p<.001），且彼此之间也有差异（p<.001）。此外，脂肪瘤的ADC值与所有其他类型相比具有统计学显著性（p<.001至.015）。在所有其他[校正后]腮腺原发性恶性肿瘤中，未观察到统计学显著的ADC值（p=.18至1）。 结论：扩散加权回波平面MRI似乎是鉴别腮腺原发性肿瘤良恶性的一种有价值的工具。
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