Thuy Tran Thi Mai, Trang Nguyen Truong Hoang, Vy Tran Thanh, Duc Vo Tan, Nam Nguyen Hoang, Chien Phan Cong, Nhi Le Huu Hanh, Minh Le Huu Nhat
Department of Diagnostic Imaging, University Medical Center, Ho Chi Minh City, Vietnam.
Department of Radiology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Front Oncol. 2022 Oct 13;12:985735. doi: 10.3389/fonc.2022.985735. eCollection 2022.
Diffusion-weighted imaging (DWI) is considered to be a useful biomarker to characterize the cellularity of lesions, yet its application in the thorax to evaluate anterior mediastinal lesions has not been well investigated. The aims of our study were to describe the magnetic resonance (MR) characteristics of anterior mediastinal masses and to assess the role of apparent diffusion coefficient (ADC) value in distinguishing benign from malignant lesions of the anterior mediastinum. We conducted a retrospective cross-sectional study including 55 patients with anterior mediastinal masses who underwent preinterventional MR scanning with the following sequences: T1 VIBE DIXON pre and post-contrast, T2 HASTE, T2 TIRM, DWI-ADC map (b values of 0 and 2000 sec/mm). The ADC measurements were obtained by two approaches: hot-spot ROI and whole-tumor histogram analysis. The lesions were grouped by three distinct ways: benign versus malignant, group A (benign lesions and type A, AB, B1 thymoma) versus group B (type B2, B3 thymoma and other malignant lesions), lymphoma versus other malignancies. The study was composed of 55 patients, with 5 benign lesions and 50 malignant lesions. The ADC, ADC, ADC, ADC in the histogram-based approach and the hot-spot-ROI-based mean ADC of the malignant lesions were significantly lower than those of benign lesions (P values< 0.05). The hot-spot-ROI-based mean ADC had the highest value in differentiation between benign and malignant mediastinal lesions, as well as between group A and group B; the ADC cutoffs (with sensitivity, specificity) to differentiate malignant from benign lesions and group A from group B were 1.17 x 10 mm/sec (80%, 80%) and 0.99 x 10 mm/sec (78.4%, 88.9%), respectively. The ADC values obtained by using the hot-spot-ROI-based and the histogram-based approaches are helpful in differentiating benign and malignant anterior mediastinal masses.
扩散加权成像（DWI）被认为是一种用于表征病变细胞密度的有用生物标志物，然而其在胸部评估前纵隔病变中的应用尚未得到充分研究。我们研究的目的是描述前纵隔肿块的磁共振（MR）特征，并评估表观扩散系数（ADC）值在鉴别前纵隔良性与恶性病变中的作用。我们进行了一项回顾性横断面研究，纳入了55例前纵隔肿块患者，这些患者在介入前接受了以下序列的MR扫描：T1 VIBE DIXON序列的增强前后扫描、T2 HASTE序列、T2 TIRM序列、DWI-ADC图（b值为0和2000 sec/mm²）。ADC测量通过两种方法获得：热点感兴趣区（ROI）和全肿瘤直方图分析。病变按三种不同方式分组：良性与恶性、A组（良性病变和A、AB、B1型胸腺瘤）与B组（B2、B3型胸腺瘤和其他恶性病变）、淋巴瘤与其他恶性肿瘤。该研究由55例患者组成，其中5例为良性病变，50例为恶性病变。基于直方图方法的ADC、基于热点ROI的恶性病变平均ADC均显著低于良性病变（P值<0.05）。基于热点ROI的平均ADC在鉴别良性与恶性纵隔病变以及A组与B组之间具有最高值；鉴别恶性与良性病变以及A组与B组的ADC临界值（敏感性、特异性）分别为1.17×10⁻³mm²/sec（80%，80%）和0.99×10⁻³mm²/sec（78.4%，88.9%）。通过基于热点ROI和基于直方图的方法获得的ADC值有助于鉴别前纵隔良性与恶性肿块。
