Department of Imaging and Interventional Radiology, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong SAR.
Eur J Radiol. 2012 Apr;81(4):784-8. doi: 10.1016/j.ejrad.2011.01.089. Epub 2011 Mar 3.
To examine the potential of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) for differential diagnosis of head and neck cancer.
DCE-MRI was performed in 26 patients with untreated squamous cell carcinoma (SCC), 28 undifferentiated carcinoma (UD) and 8 lymphoma. DCE-MRI was analyzed with the pharmacokinetic model proposed by Tofts and Kermode to produce the three DCE parameters: k(trans), v(e) and v(p). Areas under the curve (AUC) at the initial 60 and 90s (AUC60 and AUC90) were also recorded. Histogram analysis was conducted to obtain the mean, 25%, 50%, 75% and 95% percentile values and the Kruskal-Wallis test was used to compare the DCE parameters between the three groups of cancer.
k(trans), AUC60 and AUC90 showed significant differences (p<0.01) between UD/SCC and UD/lymphoma, but not between SCC/lymphoma. The mean AUC90 demonstrated the highest accuracy of 78% (sensitivity of 68% and specificity of 88%) for distinguishing UD and SCC, and the 75% percentile AUC90 provided the highest accuracy of 97% (sensitivity of 100% and specificity of 88.5%) for distinguishing UD and lymphoma.
There are significant differences in the DCE parameters which show the potential for distinguishing UD from SCC or lymphoma.
探讨动态对比增强磁共振成像（DCE-MRI）在头颈部癌症鉴别诊断中的应用价值。
对 26 例未经治疗的鳞状细胞癌（SCC）、28 例未分化癌（UD）和 8 例淋巴瘤患者进行了 DCE-MRI 检查。采用 Tofts 和 Kermode 提出的药代动力学模型对 DCE-MRI 进行分析，得到三个 DCE 参数：k(trans)、v(e)和 v(p)。还记录了初始 60 秒和 90 秒时的曲线下面积（AUC）（AUC60 和 AUC90）。进行直方图分析以获取平均值、25%、50%、75%和 95%分位数值，并使用 Kruskal-Wallis 检验比较三组癌症之间的 DCE 参数。
UD/SCC 与 UD/lymphoma 之间的 k(trans)、AUC60 和 AUC90 存在显著差异（p<0.01），但 SCC/lymphoma 之间无显著差异。AUC90 的平均值对区分 UD 和 SCC 的准确性最高，为 78%（敏感性为 68%，特异性为 88%），AUC90 的 75%分位数对区分 UD 和淋巴瘤的准确性最高，为 97%（敏感性为 100%，特异性为 88.5%）。
DCE 参数存在显著差异，具有区分 UD、SCC 或淋巴瘤的潜力。
