From the Departments of Diagnostic Radiology (A.A.K.A.R.), Chest (M.K.), and Pathology (N.N.), Mansoura Faculty of Medicine, Mansoura, Egypt 13351.
Radiology. 2014 Oct;273(1):268-75. doi: 10.1148/radiol.14131643. Epub 2014 May 31.
To assess thymic epithelial tumors with diffusion-weighted magnetic resonance (MR) imaging.
Informed consent from patients and institutional review board approval were obtained. Prospective study was conducted on 30 consecutive patients (21 men and nine women; age range, 35-71 years) with thymic epithelial tumors. They underwent true fast imaging with steady-state precession and single-shot echo-planar diffusion-weighted MR imaging of the mediastinum with b values of 0, 400, and 800 sec/mm(2). Apparent diffusion coefficient (ADC) of the thymic epithelial tumors was calculated by the same observer at two settings and was correlated with World Health Organization classification and clinical staging.
There was significant difference in longest diameter (P = .001) and necrotic part of the tumor (P = .014) between low-risk thymoma, high-risk thymoma, and thymic carcinoma. Mean ADC value of both readings of thymic epithelial tumors (n = 30) was 1.24 × 10(-3) mm(2)/sec and 1.22 × 10(-3) mm(2)/sec, with good intraobserver agreement (κ = 0.732). There was significant difference in both readings (P = .01 and .20) of low-risk thymoma (1.30 × 10(-3) mm(2)/sec and 1.29 × 10(-3) mm(2)/sec), high-risk thymoma (1.16 × 10(-3) mm(2)/sec and 1.14 × 10(-3) mm(2)/sec), and thymic carcinoma (1.18 × 10(-3) mm(2)/sec and 1.06 × 10(-3) mm(2)/sec). Cutoff ADC values of both readings used to differentiate low-risk thymoma from high-risk thymoma and thymic carcinoma were 1.25 and 1.22 × 10(-3) mm(2)/sec with area under the curve of 0.804 and 0.851, respectively. There was significant difference in both readings of ADC value of early (stage I, II) and advanced stages (stage III, IV) of thymic epithelial tumors (P = .006 and .005, respectively).
ADC value is a noninvasive, reliable, and reproducible imaging parameter that may help to assess and characterize thymic epithelial tumors.
用弥散加权磁共振成像（MR）评估胸腺瘤。
本研究获得了患者的知情同意和机构审查委员会的批准。前瞻性研究纳入了 30 例连续的胸腺瘤患者（21 名男性和 9 名女性；年龄 35~71 岁）。他们接受了真稳态进动快速成像和单次激发 echo-planar 弥散加权 MR 成像，b 值分别为 0、400 和 800 sec/mm²。由同一位观察者在两种条件下计算胸腺瘤的表观弥散系数（ADC），并与世界卫生组织（WHO）分类和临床分期相关联。
低危胸腺瘤、高危胸腺瘤和胸腺癌之间的最长径（P =.001）和肿瘤坏死部分（P =.014）有显著差异。30 例胸腺瘤的 ADC 值（n = 30）的两种测量结果的平均值分别为 1.24×10(-3)mm²/sec 和 1.22×10(-3)mm²/sec，观察者内一致性较好（κ = 0.732）。低危胸腺瘤（1.30×10(-3)mm²/sec 和 1.29×10(-3)mm²/sec）、高危胸腺瘤（1.16×10(-3)mm²/sec 和 1.14×10(-3)mm²/sec）和胸腺癌（1.18×10(-3)mm²/sec 和 1.06×10(-3)mm²/sec）的两种测量结果均有显著差异（P =.01 和.20）。两种测量结果用于区分低危胸腺瘤和高危胸腺瘤及胸腺癌的 ADC 值截断值分别为 1.25 和 1.22×10(-3)mm²/sec，曲线下面积分别为 0.804 和 0.851。胸腺瘤的早期（Ⅰ期和Ⅱ期）和晚期（Ⅲ期和Ⅳ期）ADC 值的两种测量结果有显著差异（P =.006 和.005）。
ADC 值是一种无创、可靠且可重复的成像参数，有助于评估和特征化胸腺瘤。
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