Department of Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland).
Med Sci Monit. 2018 Jul 4;24:4610-4616. doi: 10.12659/MSM.911185.
BACKGROUND The aim of this study was to investigate the diagnostic value of diffusion-weighted imaging (DWI) in combination with susceptibility-weighted imaging (SWI) for differentiating benign parotid gland lesions from malignant ones. MATERIAL AND METHODS This retrospective study was approved by the Ethics Committee of our hospital. A total of 36 patients (26 benign cases and 10 malignant cases) were confirmed by surgical pathology. The apparent diffusion coefficient (ADC), normalized ADC (ADCNormalized), intratumoral susceptibility signals (ITSS), and morphological characteristics were analyzed with SPSS 19.0 software. RESULTS The mean ADC values of parotid gland lesions was not different between malignant and benign lesions (P=0.07), while the differences between ADCNormalized (P=0.026) and ITSS grading (P=0.014) were statistically significant. Logistic regression analysis identified use of ADCNormalized and ITSS as the only independent predictor of malignant lesions (odds ratio 0.038; 95% confidence interval 0.0010.988; P=0.011) and (odds ratio 4.867; 95% confidence interval 1.44216.423; P=0.049), respectively. The optimum threshold of the ADCNormalized values was -0.45%, ITSS grade was 2, the corresponding areas under the receiver operating characteristic curve (AUC) were 0.750 and 0.787 respectively, and the combination of the 2 was 0.846. CONCLUSIONS DWI integrated with SWI can significantly improve the diagnostic efficacy in distinguishing benign from malignant parotid lesions.
本研究旨在探讨扩散加权成像(DWI)联合磁敏感加权成像(SWI)对鉴别腮腺良恶性病变的诊断价值。
本回顾性研究经我院伦理委员会批准。共纳入 36 例患者(26 例良性,10 例恶性),均经手术病理证实。采用 SPSS 19.0 软件分析表观扩散系数(ADC)、标准化 ADC(ADCNormalized)、瘤内磁敏感信号(ITSS)和形态学特征。
恶性与良性腮腺病变的平均 ADC 值无统计学差异(P=0.07),而 ADCNormalized(P=0.026)和 ITSS 分级(P=0.014)之间的差异有统计学意义。Logistic 回归分析发现,ADCNormalized 和 ITSS 分级是恶性病变的唯一独立预测因素(比值比 0.038;95%置信区间 0.0010.988;P=0.011)和(比值比 4.867;95%置信区间 1.44216.423;P=0.049)。ADCNormalized 值的最佳截断值为-0.45%,ITSS 分级为 2,相应的受试者工作特征曲线(ROC)下面积分别为 0.750 和 0.787,两者联合的 AUC 为 0.846。
DWI 联合 SWI 可显著提高鉴别腮腺良恶性病变的诊断效能。