Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Clin Radiol. 2020 Jul;75(7):560.e19-560.e25. doi: 10.1016/j.crad.2020.02.010. Epub 2020 Mar 17.
To evaluate the value of using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) derived parameters to differentiate thymic carcinoma and thymic lymphoma based on semi-quantitative and quantitative models.
Twenty-nine pathologically confirmed anterior mediastinum tumours in 29 patients were enrolled in this retrospective study, including 15 thymic carcinoma and 14 lymphoma patients. All the patients underwent pre-treatment mediastinum DCE-MRI. Both semi-quantitative and quantitative parameters were calculated and the volume transfer constant K, the flux rate constant between extravascular extracellular space and plasma k, the extravascular extracellular volume fraction v were obtained based on a modified Tofts model. DCE-MRI derived parameters were compared between thymic carcinoma and thymic lymphoma groups.
Thymic carcinoma had significantly lower k (p=0.040) and higher v (p=0.018) than thymic lymphoma; however, there were no significant differences on K and semi-quantitative parameters between the two groups. v had the highest area under the curve (cut-off value, 0.282; area under the curve, 0.748; sensitivity, 71.4%; specificity, 80%). The combination of k and v could increase the diagnostic performance significantly (area under the curve, 0.752; sensitivity, 57.1%; specificity, 93.3%).
DCE-MRI derived parameters may have value in the differentiating thymic carcinoma and thymic lymphoma.
评估使用动态对比增强磁共振成像(DCE-MRI)衍生参数基于半定量和定量模型区分胸腺癌和胸腺瘤的价值。
本回顾性研究纳入了 29 例经病理证实的前纵隔肿瘤患者,包括 15 例胸腺癌和 14 例淋巴瘤患者。所有患者均行治疗前纵隔 DCE-MRI 检查。计算半定量和定量参数,并基于改良 Tofts 模型获得容积转移常数 K、血管外细胞外间隙与血浆间的流量常数 k、血管外细胞外容积分数 v。比较胸腺癌和胸腺瘤组之间的 DCE-MRI 衍生参数。
胸腺癌的 k 值明显低于胸腺瘤(p=0.040),v 值明显高于胸腺瘤(p=0.018);然而,两组间 K 和半定量参数无显著差异。v 具有最高的曲线下面积(截断值为 0.282;曲线下面积为 0.748;敏感性为 71.4%;特异性为 80%)。k 和 v 的组合可显著提高诊断性能(曲线下面积为 0.752;敏感性为 57.1%;特异性为 93.3%)。
DCE-MRI 衍生参数在区分胸腺癌和胸腺瘤方面可能具有一定价值。