螺旋桨扩散加权磁共振成像的成像质量及其对鉴别腮腺多形性腺瘤和沃辛瘤的诊断性能。
Imaging quality of PROPELLER diffusion-weighted MR imaging and its diagnostic performance in distinguishing pleomorphic adenomas from Warthin tumors of the parotid gland.
机构信息
Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan, Republic of China.
Electrical and Communication Engineering, Feng Chia University, Taichung, Taiwan, Republic of China.
出版信息
NMR Biomed. 2020 May;33(5):e4282. doi: 10.1002/nbm.4282. Epub 2020 Mar 2.
The aim of this study was to evaluate the imaging quality and diagnostic performance of fast spin echo diffusion-weighted imaging with periodically rotated overlapping parallel lines with enhanced reconstruction (FSE-PROP-DWI) in distinguishing parotid pleomorphic adenoma (PMA) from Warthin tumor (WT). This retrospective study enrolled 44 parotid gland tumors from 34 patients, including 15 PMAs and 29 WTs with waived written informed consent. All participants underwent 1.5 T diffusion-weighted imaging including FSE-PROP-DWI and single-shot echo-planar diffusion-weighted imaging (SS-EP-DWI). After imaging resizing and registration among T2WI, FSE-PROP-DWI and SS-EP-DWI, imaging distortion was quantitatively analyzed by using the Dice coefficient. Signal-to-noise ratio and contrast-to-noise ratio were qualitatively evaluated. The mean apparent diffusion coefficient (ADC) of parotid gland tumors was calculated. Wilcoxon signed-rank test was used for paired comparison between FSE-PROP-DWI versus SS-EP-DWI. Mann-Whitney U test was used for independent group comparison between PMAs versus WTs. Diagnostic performance was evaluated by receiver operating characteristics curve analysis. P < 0.05 was considered statistically significant. The Dice coefficient was statistically significantly higher on FSE-PROP-DWI than SS-EP-DWI for both tumors (P < 0.005). Mean ADC was statistically significantly higher in PMAs than WTs on both FSE-PROP-DWI and SS-EP-DWI (P < 0.005). FSE-PROP-DWI and SS-EP-DWI successfully distinguished PMAs from WTs with an AUC of 0.880 and 0.945, respectively (P < 0.05). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy in diagnosing PMAs were 100%, 69.0%, 62.5%, 100% and 79.5% for FSE-PROP-DWI, and 100%, 82.8%, 75%, 100% and 88.6% for SS-EP-DWI, respectively. FSE-PROP-DWI is useful to distinguish parotid PMAs from WTs with less distortion of tumors but lower AUC than SS-EP-DWI.
本研究旨在评估快速自旋回波弥散加权成像（FSE-PROP-DWI）与周期性旋转重叠平行线增强重建（FSE-PROP-DWI）在鉴别腮腺多形性腺瘤（PMA）与沃辛瘤（WT）中的成像质量和诊断性能。这项回顾性研究纳入了 34 名患者的 44 个腮腺肿瘤，包括 15 个 PMA 和 29 个 WT，均豁免了书面知情同意。所有参与者均接受了 1.5T 弥散加权成像，包括 FSE-PROP-DWI 和单次激发回波平面弥散加权成像（SS-EP-DWI）。在 T2WI、FSE-PROP-DWI 和 SS-EP-DWI 之间进行图像调整和注册后，使用 Dice 系数定量分析图像失真。定性评估信噪比和对比噪声比。计算腮腺肿瘤的平均表观弥散系数（ADC）。采用 Wilcoxon 符号秩检验对 FSE-PROP-DWI 与 SS-EP-DWI 进行配对比较。采用 Mann-Whitney U 检验对 PMA 与 WT 进行独立组比较。通过受试者工作特征曲线分析评估诊断性能。P<0.05 为差异有统计学意义。对于两种肿瘤，FSE-PROP-DWI 的 Dice 系数均显著高于 SS-EP-DWI（P<0.005）。在 FSE-PROP-DWI 和 SS-EP-DWI 上，PMA 的平均 ADC 均显著高于 WT（P<0.005）。FSE-PROP-DWI 和 SS-EP-DWI 分别成功鉴别 PMA 和 WT，曲线下面积分别为 0.880 和 0.945（P<0.05）。FSE-PROP-DWI 诊断 PMA 的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 100%、69.0%、62.5%、100%和 79.5%，SS-EP-DWI 分别为 100%、82.8%、75%、100%和 88.6%。FSE-PROP-DWI 有助于鉴别腮腺 PMA 与 WT，其肿瘤失真较小，但 AUC 低于 SS-EP-DWI。
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