Liu Renwei, Li Jianhua, Jiang Yixiang, Wu Zhiqing, Ji Jiayin, Li Aibo, Wang Xiaoping, Li Ruifeng
Department of Radiology, People's Hospital of Longhua District, The Affiliated Hospital of Southern Medical University, Shenzhen, China.
Acta Radiol. 2022 Mar;63(3):416-423. doi: 10.1177/0284185121991980. Epub 2021 Feb 8.
Diffusion-weighted imaging (DWI) can quantitatively reflect the diffusion characteristics of tissues, providing a theoretical basis for qualitative diagnosis and quantitative analysis of a disease.
To characterize testicular lesions that present as a hypointense signal on magnetic resonance imaging (MRI) T2-weighted images using DWI.
Study participants were divided into three groups. Group A were healthy controls (n = 35), group B included patients with mumps orchitis (n = 20), and group C included patients with seminoma (n = 15). DWI sequences used b-values of 0, 1000, and 2000 s/mm. Apparent diffusion coefficient (ADC) values between 1000 and 2000 s/mm were calculated by MRI postprocessing software. The Kruskal-Wallis test and receiver operating characteristic analysis were performed to evaluate how well ADC values distinguished between mumps orchitis and seminoma.
Normal testicular tissue showed a hyperintense signal on DWI and hypointensity on the ADC map: mean ADC value was 0.77 (0.69-0.85) ± 0.08 ×10 mm/s. Mumps orchitis and seminoma showed slight hyperintensity on DWI: mean ADC values were 0.85 (0.71-0.99) ± 0.15 ×10 mm/s and 0.43 (0.39-0.47) ± 0.04 × 10 mm/s, respectively. There were statistically significant differences in mean ADC values between normal testicular tissue and seminoma and between mumps orchitis and seminoma. The cutoff ADC value for differentiating seminoma from mumps orchitis was 0.54 × 10 mm/s. The sensitivity, specificity, and Youden Index for diagnosing seminoma were 99%, 31%, and 30%, respectively.
High b-value DWI has potential utility for differentiating mumps orchitis from seminoma in the clinical setting.
扩散加权成像（DWI）能够定量反映组织的扩散特性，为疾病的定性诊断和定量分析提供理论依据。
利用DWI对磁共振成像（MRI）T2加权图像上表现为低信号的睾丸病变进行特征描述。
研究参与者分为三组。A组为健康对照组（n = 35），B组包括流行性腮腺炎睾丸炎患者（n = 20），C组包括精原细胞瘤患者（n = 15）。DWI序列使用的b值为0、1000和2000 s/mm²。通过MRI后处理软件计算1000至2000 s/mm²之间的表观扩散系数（ADC）值。采用Kruskal-Wallis检验和受试者工作特征分析来评估ADC值区分流行性腮腺炎睾丸炎和精原细胞瘤的能力。
正常睾丸组织在DWI上表现为高信号，在ADC图上表现为低信号：平均ADC值为0.77（0.69 - 0.85）±0.08×10⁻³mm²/s。流行性腮腺炎睾丸炎和精原细胞瘤在DWI上表现为轻度高信号：平均ADC值分别为0.85（0.71 - 0.99）±0.15×10⁻³mm²/s和0.43（0.39 - 0.47）±0.04×10⁻³mm²/s。正常睾丸组织与精原细胞瘤之间以及流行性腮腺炎睾丸炎与精原细胞瘤之间的平均ADC值存在统计学显著差异。区分精原细胞瘤与流行性腮腺炎睾丸炎的ADC临界值为0.54×10⁻³mm²/s。诊断精原细胞瘤的敏感性、特异性和尤登指数分别为99%、31%和30%。
高b值DWI在临床环境中对于区分流行性腮腺炎睾丸炎和精原细胞瘤具有潜在应用价值。
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