Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Department of Pathology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
Clin Radiol. 2021 Jun;76(6):472.e19-472.e25. doi: 10.1016/j.crad.2021.02.011. Epub 2021 Mar 14.
To investigate the efficacy of the maximum signal intensity of tumour on T1-weighted magnetic resonance imaging (MRI) images for differentiating Warthin's tumours (WTs) from pleomorphic adenomas (PAs) and malignant tumours (MTs).
One hundred and fifty-four histopathologically confirmed parotid tumours, including 76 PAs, 45 WTs, and 33 MTs, were analysed. MRI results were compared with pathological findings. The maximum signal intensity of tumour and the average signal intensity of spinal cord were measured on T1-weighted images, then the tumour-to-spinal cord signal intensity ratio (T1-max-SIR) was calculated. The distribution of T1-max-SIRs among the three groups of tumours was analysed using the Mann-Whitney U-test. Receiver operating characteristic curves were generated to assess the ability of T1-max-SIRs to differentiate parotid tumours. In addition, the interobserver agreement between readers was assessed using interclass correlation coefficient (ICC).
T1-max-SIRs were higher in WTs than in PAs (p<0.001) and MTs (p<0.001), and no significant difference was found between PAs and MTs (p=0.151). The area under the curve (AUC) of T1-max-SIRs for differentiating WTs from PAs was 0.901, with a sensitivity of 91.1% and a specificity of 82.9%. The AUC of T1-max-SIRs for differentiating WTs from MTs was 0.851, with a sensitivity of 88.9% and a specificity of 78.8%. Readers had excellent interobserver agreement on T1-max-SIRs (ICC = 0.989; 95% confidence interval, 0.985-0.992).
T1-max-SIRs can be useful for differentiating WTs from PAs and MTs with high diagnostic efficiency.
探讨 T1 加权磁共振成像（MRI）图像中肿瘤最大信号强度用于鉴别沃辛瘤（WTs）与多形性腺瘤（PAs）和恶性肿瘤（MTs）的效果。
分析了 154 例经组织病理学证实的腮腺肿瘤，包括 76 例 PAs、45 例 WTs 和 33 例 MTs。将 MRI 结果与病理结果进行比较。在 T1 加权图像上测量肿瘤的最大信号强度和脊髓的平均信号强度，然后计算肿瘤与脊髓的信号强度比（T1-max-SIR）。采用 Mann-Whitney U 检验分析三组肿瘤 T1-max-SIR 的分布情况。绘制受试者工作特征曲线评估 T1-max-SIR 鉴别腮腺肿瘤的能力。此外，采用组内相关系数（ICC）评估观察者间的一致性。
WTs 的 T1-max-SIR 高于 PAs（p<0.001）和 MTs（p<0.001），PAs 与 MTs 之间无显著差异（p=0.151）。T1-max-SIR 鉴别 WTs 与 PAs 的曲线下面积（AUC）为 0.901，灵敏度为 91.1%，特异性为 82.9%。T1-max-SIR 鉴别 WTs 与 MTs 的 AUC 为 0.851，灵敏度为 88.9%，特异性为 78.8%。观察者对 T1-max-SIR 的一致性极好（ICC=0.989；95%置信区间，0.985-0.992）。
T1-max-SIR 可有效鉴别 WTs 与 PAs 和 MTs，诊断效率高。
