Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, China.
Clinical Center for Eye Tumors, Capital Medical University, Beijing, China.
Neuroradiology. 2020 Sep;62(9):1141-1147. doi: 10.1007/s00234-020-02455-3. Epub 2020 May 19.
To evaluate the diagnostic performance of the quantitative parameters derived from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) MRI in differentiating lacrimal gland pleomorphic adenomas (LGPAs) from lacrimal gland malignant epithelial tumors (LGMETs).
Seventy-seven cases with LG epithelial tumors confirmed by histopathology (47 LGPAs and 30 LGMETs) underwent DWI and DCE-MRI. The quantitative parameters including the apparent diffusion coefficient (ADC), the volume transfer constant (K), the efflux rate constant from the extravascular extracellular space (EES) to blood plasma (K), and the extravascular extracellular volume fraction (V) were used to differentiate LGPAs from LGMETs. Independent-samples t test was conducted to compare these parameters. The diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis.
Compared with LGPAs, LGMETs had significantly lower ADC value (1.090 ± 0.169mm/s) (P < 0.001), higher K value (0.892 ± 0.517/min) (P = 0.001), and K value (1.300 ± 1.131/min) (P = 0.002). ADC as a diagnostic index showed a better diagnostic efficacy in predicting malignant tumors (AUC 0.914, sensitivity 90.0%, specificity 85.1%, and accuracy 87.0%) than K and K alone. The combination of ADC and K presented the optimal diagnostic performance for the differentiation (AUC 0.938, sensitivity 93.3%, specificity 87.2%, accuracy 89.6%).
The quantitative parameters including ADC, K, and K derived from DWI and DCE-MRI might be potential imaging biomarkers in differentiating LGPAs from LGMETs. The combination of ADC and K is superior to other quantitative parameters in distinguishing LGPAs from LGMETs.
评估扩散加权成像（DWI）和动态对比增强（DCE）MRI 定量参数在鉴别泪腺多形性腺瘤（LGPAs）和泪腺恶性上皮肿瘤（LGMETs）中的诊断性能。
对 77 例经组织病理学证实的 LG 上皮肿瘤患者（47 例 LGPAs 和 30 例 LGMETs）进行 DWI 和 DCE-MRI 检查。使用表观扩散系数（ADC）、容积转移常数（K）、血管外细胞外间隙（EES）到血浆的流出率常数（K）和血管外细胞外容积分数（V）等定量参数来鉴别 LGPAs 和 LGMETs。采用独立样本 t 检验比较这些参数。采用受试者工作特征（ROC）曲线分析评估诊断性能。
与 LGPAs 相比，LGMETs 的 ADC 值（1.090±0.169mm/s）显著降低（P<0.001），K 值（0.892±0.517/min）和 K 值（1.300±1.131/min）显著升高（P=0.001、P=0.002）。作为诊断指标的 ADC 在预测恶性肿瘤方面具有更好的诊断效能（AUC 0.914、敏感度 90.0%、特异度 85.1%和准确率 87.0%），优于单独的 K 和 K。ADC 与 K 联合应用具有最佳的鉴别诊断效能（AUC 0.938、敏感度 93.3%、特异度 87.2%和准确率 89.6%）。
DWI 和 DCE-MRI 定量参数（包括 ADC、K 和 K）可能是鉴别 LGPAs 和 LGMETs 的潜在影像学生物标志物。ADC 与 K 的联合应用在鉴别 LGPAs 和 LGMETs 方面优于其他定量参数。
