Zhang Wei, Zuo Zhichao, Luo Ningbin, Liu Lianfeng, Jin Guanqiao, Liu Junjie, Su Danke
Department of Radiology, Affiliated Tumor Hospital of Guangxi Medical University, 71 Hedi Road, Nanning, 530021, Guangxi, China.
Department of Ultrasound Diagnosis, Affiliated Tumor Hospital of Guangxi Medical University, 71 Hedi Road, Nanning, 530021, Guangxi, China.
Eur Arch Otorhinolaryngol. 2018 Apr;275(4):987-995. doi: 10.1007/s00405-018-4895-6. Epub 2018 Feb 12.
To determine the value of non-enhanced MRI in combination with color Doppler flow imaging (CDFI) for differentiating malignant parotid tumors from benign ones.
This retrospective study analyzed 51 parotid gland lesions (39 benign and 12 malignant) in 51 patients who underwent preoperative CDFI as well as non-enhanced MRI including T-weighted, T-weighted, and diffusion-weighted imaging (DWI). Degrees of intratumor vascularity were categorized into four grades basing on CDFI findings. The relationships between the lesion and its adjacent external carotid artery and retromandibular vein were inspected on T-weighted and T-weighted images. Apparent diffusion coefficient (ADC) values were calculated from diffusion-weighted images, and were used to classify the parotid gland lesions with and without reference to the CDFI findings. The classification results were compared using the McNemar test. Sensitivity, specificity, and accuracy percentages were calculated when the non-enhanced MRI/CDFI findings were used to differentiate benign lesions from malignant ones.
The diagnostic accuracy (96.1 vs 82.4%) was significantly improved when ADCs were used together with CDFI findings for classifying parotid gland lesions compared to when ADCs were used alone. Pleomorphic adenomas had the highest ADCs. The ADC thresholds were 1.425 × 10 mm/s for differentiating pleomorphic adenomas from carcinomas, 0.999 × 10 mm/s for differentiating pleomorphic adenomas from other benign lesions, and 0.590 × 10 mm/s for differentiating benign lesions other than pleomorphic adenomas from lymphomas.
Combining CDFI with non-enhanced MRI can improve the diagnostic accuracy of MRI for classifying parotid gland lesions.
确定非增强磁共振成像（MRI）联合彩色多普勒血流成像（CDFI）鉴别腮腺恶性肿瘤与良性肿瘤的价值。
本回顾性研究分析了51例患者的51个腮腺病变（39个良性和12个恶性），这些患者术前行CDFI检查以及包括T加权、T加权和扩散加权成像（DWI）的非增强MRI检查。根据CDFI检查结果，将肿瘤内血管程度分为四级。在T加权和T加权图像上观察病变与其相邻颈外动脉和下颌后静脉的关系。从扩散加权图像计算表观扩散系数（ADC）值，并用于在参考和不参考CDFI检查结果的情况下对腮腺病变进行分类。使用McNemar检验比较分类结果。当使用非增强MRI/CDFI检查结果鉴别良性病变与恶性病变时，计算敏感性、特异性和准确率。
与单独使用ADC值相比，将ADC值与CDFI检查结果一起用于腮腺病变分类时，诊断准确率（96.1%对82.4%）显著提高。多形性腺瘤的ADC值最高。鉴别多形性腺瘤与癌的ADC阈值为1.425×10⁻³mm²/s，鉴别多形性腺瘤与其他良性病变的ADC阈值为0.999×10⁻³mm²/s，鉴别多形性腺瘤以外的良性病变与淋巴瘤的ADC阈值为0.590×10⁻³mm²/s。
CDFI与非增强MRI联合应用可提高MRI对腮腺病变分类的诊断准确率。
