Department of Radiology, Wuhu Second People's Hospital, Wuhu, China.
Department of Radiology, Jining No.1 People's Hospital, Jining, China.
J Magn Reson Imaging. 2022 Feb;55(2):414-423. doi: 10.1002/jmri.27885. Epub 2021 Aug 10.
Preoperative differentiation of head and neck lesions is important for treatment plan selection.
To evaluate the diagnostic value of diffusion kurtosis imaging (DKI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating benign from malignant head and neck lesions and subgroups, including lymphoma subgroup (LS), Warthin's tumor subgroup (WS), malignant tumor subgroup (excluding lymphoma) (MTS), and benign tumor subgroup (excluding Warthin's tumor) (BTS).
Retrospective.
Seventy-four patients with 79 head and neck lesions (44 benign, 35 malignant), divided into four subgroups: LS (14), WS (12), MTS (21), and BTS (32).
FIELD STRENGTH/SEQUENCES: A 3.0 T, single-shot echo-planar sequence with 5 b-values for DKI and enhanced T1 high-resolution isotropic volume excitation (eTHRIVE) sequence for DCE-MRI.
The mean diffusivity (MD) and mean kurtosis (MK) derived from DKI and the time-signal intensity curve (TIC), peak time (T ), and washout ratio (WR) based on DCE-MRI were measured. The diagnostic efficiencies of DKI and DCE-MRI, alone and in combination, were calculated and compared. The parameters mentioned above were compared between the four subgroups.
Mann-Whitney U test, chi-square test, receiver operating characteristic curve, Delong test, one-way analysis of variance test, and Kruskal-Wallis H test. A P value < 0.05 was considered statistically significant.
The combination of TIC and parameters of DKI and DCE-MRI for differentiating benign and malignant lesions with 94.94% accuracy is superior to DKI or DCE-MRI alone with approximately 75% accuracy. MD, MK, T , and WR showed significant differences among the four subgroups. The accuracy of MD and MK was 91.14% and 92.41% for differentiating BTS from the other three subgroups. WR achieved 100% accuracy for discriminating WS from LS or MTS. MD and MK both differentiated LS from MTS with 97.14% accuracy.
A combination of DKI and DCE-MRI can effectively differentiate head and neck lesions with good accuracy.
3 TECHNICAL EFFICACY: Stage 2.
术前对头颈部病变进行鉴别对于治疗方案的选择很重要。
评估扩散峰度成像（DKI）和动态对比增强磁共振成像（DCE-MRI）在鉴别头颈部良恶性病变及亚组，包括淋巴瘤亚组（LS）、Warthin 瘤亚组（WS）、恶性肿瘤亚组（除外淋巴瘤）（MTS）和良性肿瘤亚组（除外 Warthin 瘤）（BTS）中的诊断价值。
回顾性。
74 例患者共 79 个头颈部病变（44 个良性，35 个恶性），分为四个亚组：LS（14 个）、WS（12 个）、MTS（21 个）和 BTS（32 个）。
磁场强度/序列：3.0T，单次激发回波平面序列，DKI 采用 5 个 b 值，DCE-MRI 采用增强 T1 高分辨率各向同性激发（eTHRIVE）序列。
测量来自 DKI 的平均扩散系数（MD）和平均峰度（MK），以及基于 DCE-MRI 的时间信号强度曲线（TIC）、峰值时间（T）和洗脱率（WR）。计算并比较 DKI 和 DCE-MRI 单独及联合的诊断效能，并比较以上参数在四个亚组间的差异。
Mann-Whitney U 检验、卡方检验、受试者工作特征曲线、Delong 检验、单因素方差分析检验和 Kruskal-Wallis H 检验。P 值＜0.05 为统计学显著差异。
TIC 联合 DKI 和 DCE-MRI 参数鉴别良恶性病变的准确率为 94.94%，优于单独使用 DKI 或 DCE-MRI 的准确率（约 75%）。MD、MK、T 和 WR 在四个亚组间差异有统计学意义。MD 和 MK 鉴别 BTS 与其他三个亚组的准确率分别为 91.14%和 92.41%。WR 鉴别 WS 与 LS 或 MTS 的准确率为 100%。MD 和 MK 鉴别 LS 与 MTS 的准确率均为 97.14%。
DKI 和 DCE-MRI 联合使用可以有效鉴别头颈部病变，具有较好的准确性。
3 级 技术效能：2 级
