Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China.
GE Healthcare China, Beijing, China.
Eur J Radiol. 2020 Sep;130:109191. doi: 10.1016/j.ejrad.2020.109191. Epub 2020 Jul 25.
To investigate the utility of intravoxel incoherent motion diffusion-weighted MRI (IVIM-DWI) derived diffusion and perfusion parameters in differentiating ocular adnexal lymphoma (OAL) from idiopathic orbital inflammation (IOI), and to assess whether IVIM-DWI provides improved diagnostic performance for the distinction.
Twenty-one patients with OAL and 24 patients with IOI underwent IVIM-DWI. Apparent diffusion coefficient (ADC) and IVIM-DWI parameters including true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were measured in lesions by two independent radiologists. The MRI parameter differences between OAL and IOI were tested using two-sample t-test. The receiver operating characteristic (ROC) analysis curves were used to determine the diagnostic performance of significant parameters for differentiation between OAL and IOI.
The ADC, D, and f were lower in OAL than those in IOI (ADC = 0.78 ± 0.12 vs. 0.99 ± 0.16 × 10 mm/s, P < 0.001; D = 0.34 ± 0.15 vs. 0.76 ± 0.25 × 10 mm/s, P < 0.001; f = 0.31 ± 0.06 vs. 0.41 ± 0.08 × 100 %, P < 0.001). There was no significant difference in D* between OAL and IOI (P = 0.235). The optimal cut-off values of ADC, D, and f in differentiating OAL from IOI were 0.83 × 10 mm/s, 0.56 × 10 mm/s, and 0.36 × 100 %, respectively. No significant differences were found in areas under the curve (AUCs) among ADC, D and f (all P > 0.05). The combination of D and f provided significantly higher AUC than ADC (AUC = 0.984 vs. 0.838, Z = 2.128, P = 0.033), and had higher sensitivity of 95.24 %, specificity of 95.83 %, and accuracy of 95.56 %.
IVIM-DWI is valuable in differentiating OAL from IOI, and D combined f can improve the performance of differential diagnosis.
探讨体素内不相干运动（IVIM）扩散加权磁共振成像（DWI）衍生的扩散和灌注参数在鉴别眼眶附属器淋巴瘤（OAL）与特发性眼眶炎症（IOI）中的作用，并评估 IVIM-DWI 对鉴别诊断的诊断性能是否有提高。
21 例 OAL 患者和 24 例 IOI 患者均行 IVIM-DWI 检查。两名独立的放射科医生在病变中测量表观扩散系数（ADC）和 IVIM-DWI 参数，包括真实扩散系数（D）、假性扩散系数（D*）和灌注分数（f）。使用两样本 t 检验比较 OAL 和 IOI 之间的 MRI 参数差异。受试者工作特征（ROC）分析曲线用于确定用于区分 OAL 和 IOI 的显著参数的诊断性能。
OAL 的 ADC、D 和 f 均低于 IOI（ADC=0.78±0.12 与 0.99±0.16×10mm/s，P＜0.001；D=0.34±0.15 与 0.76±0.25×10mm/s，P＜0.001；f=0.31±0.06 与 0.41±0.08×100%，P＜0.001）。OAL 和 IOI 之间的 D* 无显著差异（P=0.235）。区分 OAL 和 IOI 的 ADC、D 和 f 的最佳截断值分别为 0.83×10mm/s、0.56×10mm/s 和 0.36×100%。ADC、D 和 f 的曲线下面积（AUCs）之间无显著差异（均 P＞0.05）。D 和 f 的组合提供的 AUC 显著高于 ADC（AUC=0.984 与 0.838，Z=2.128，P=0.033），且具有 95.24%的更高敏感性、95.83%的特异性和 95.56%的准确性。
IVIM-DWI 有助于鉴别 OAL 与 IOI，D 与 f 的组合可提高鉴别诊断的效能。
