Department of Radiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
GE Healthcare, MR Research China, Beijing, China.
Eur Radiol. 2024 Oct;34(10):6820-6830. doi: 10.1007/s00330-024-10696-6. Epub 2024 Mar 16.
OBJECTIVES: To explore the value of the synthetic MRI (SyMRI), combined with amide proton transfer-weighted (APTw) MRI for quantitative and morphologic assessment of sinonasal lesions, which could provide relative scale for the quantitative assessment of tissue properties. METHODS: A total of 80 patients (31 malignant and 49 benign) with sinonasal lesions, who underwent the SyMRI and APTw examination, were retrospectively analyzed. Quantitative parameters (T1, T2, proton density (PD)) and APT % were obtained through outlining the region of interest (ROI) and comparing the two groups utilizing independent Student t test or a Wilcoxon test. Receiver operating characteristic curve (ROC), Delong test, and logistic regression analysis were performed to assess the diagnostic efficiency of one-parameter and multiparametric models. RESULTS: SyMRI-derived mean T1, T2, and PD were significantly higher and APT % was relatively lower in benign compared to malignant sinonasal lesions (p < 0.05). The ROC analysis showed that the AUCs of the SyMRI-derived quantitative (T1, T2, PD) values and APT % ranged from 0.677 to 0.781 for differential diagnosis between benign and malignant sinonasal lesions. The T2 values showed the best diagnostic performance among all single parameters for differentiating these two masses. The AUCs of combined SyMRI-derived multiple parameters with APT % (AUC = 0.866) were the highest than that of any single parameter, which was significantly improved (p < 0.05). CONCLUSION: The combination of SyMRI and APTw imaging has the potential to reflect intrinsic tissue characteristics useful for differentiating benign from malignant sinonasal lesions. CLINICAL RELEVANCE STATEMENT: Combining synthetic MRI with amide proton transfer-weighted imaging could function as a quantitative and contrast-free approach, significantly enhancing the differentiation of benign and malignant sinonasal lesions and overcoming the limitations associated with the superficial nature of endoscopic nasal sampling. KEY POINTS: • Synthetic MRI and amide proton transfer-weighted MRI could differentiate benign from malignant sinonasal lesions based on quantitative parameters. • The diagnostic efficiency could be significantly improved through synthetic MRI + amide proton transfer-weighted imaging. • The combination of synthetic MRI and amide proton transfer-weighted MRI is a noninvasive method to evaluate sinonasal lesions.
目的：探讨合成磁共振成像（SyMRI）联合酰胺质子转移加权（APTw）磁共振成像在评估鼻-鼻窦病变的定量和形态学方面的价值，为组织特性的定量评估提供相对尺度。
方法：回顾性分析 80 例（31 例恶性，49 例良性）鼻-鼻窦病变患者的 SyMRI 和 APTw 检查资料。通过勾画感兴趣区（ROI）获得定量参数（T1、T2、质子密度（PD））和 APT%，并利用独立样本 t 检验或 Wilcoxon 检验比较两组间的差异。采用受试者工作特征曲线（ROC）、DeLong 检验和 logistic 回归分析评估单参数和多参数模型的诊断效能。
结果：良性鼻-鼻窦病变的平均 SyMRI 衍生 T1、T2 和 PD 值较高，APTw%值较低（p<0.05）。ROC 分析显示，SyMRI 衍生定量（T1、T2、PD）值和 APT%值在鉴别良恶性鼻-鼻窦病变中的 AUC 范围为 0.677~0.781。在所有单参数中，T2 值对鉴别这两种病变的诊断效能最佳。与任何单一参数相比，联合 SyMRI 衍生多个参数与 APT%（AUC=0.866）的 AUC 最高，且差异具有统计学意义（p<0.05）。
结论：SyMRI 联合 APTw 成像有可能反映有助于鉴别良恶性鼻-鼻窦病变的内在组织特征。
临床相关性声明：联合使用合成磁共振成像和酰胺质子转移加权成像可以作为一种定量且无对比剂的方法，显著提高良恶性鼻-鼻窦病变的鉴别能力，并克服了鼻内镜下鼻腔取样的表面性质所带来的局限性。
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