Zhou Lina, Peng Qin, Tang Wei, Wu Ning, Yang Lin, Qi Linlin, Li Jiang, Huang Yao
Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China.
J Magn Reson Imaging. 2025 Feb;61(2):841-848. doi: 10.1002/jmri.29481. Epub 2024 Jun 10.
Preoperative differentiation of the types of mediastinal tumors is essential. Magnetic resonance (MR) elastography potentially provides a noninvasive method to assess the classification of mediastinal tumor subtypes.
To evaluate the use of MR elastography in anterior mediastinal masses and to characterize the mechanical properties of tumors of different subtypes.
Prospective.
189 patients with anterior mediastinal tumors (AMTs) confirmed by histopathology (62 thymomas, 53 thymic carcinomas, 57 lymphomas, and 17 germ cell tumors).
FIELD STRENGTH/SEQUENCE: A gradient echo-based 2D MR elastography sequence and a diffusion-weighted imaging (DWI) sequence at 3.0 T.
Stiffness and apparent diffusion coefficients (ADC) were measured in AMTs using MR elastography-derived elastograms and DWI-derived ADC maps, respectively. The aim of this study is to identify whether MR elastography can differentiate between the histological subtypes of ATMs.
One-way analysis of variance (ANOVA), two-way ANOVA, Pearson's linear correlation coefficient (r), receiver operating characteristic (ROC) curve analysis; P < 0.05 was considered significant.
Lymphomas had significantly lower stiffness than other AMTs (4.0 ± 0.63 kPa vs. 4.8 ± 1.39 kPa). The mean stiffness of thymic carcinomas was significantly higher than that of other AMTs (5.6 ± 1.41 kPa vs. 4.2 ± 0.94 kPa). Using a cutoff value of 5.0 kPa, ROC analysis showed that lymphomas could be differentiated from other AMTs with an accuracy of 59%, sensitivity of 97%, and specificity of 38%. Using a cutoff value of 5.1 kPa, thymic carcinomas could be differentiated from other AMTs with an accuracy of 84%, sensitivity of 67%, and specificity of 90%. However, there was an overlap in the stiffness values of individual thymomas (4.2 ± 0.71; 3.9-4.5), thymic carcinomas (5.6 ± 1.41; 5.0-6.1), lymphomas (4.0 ± 0.63; 3.8-4.2), and germ cell tumors (4.5 ± 1.79; 3.3-5.6).
MR elastography-derived stiffness may be used to evaluate AMTs of various histologies.
Stage 2.
术前区分纵隔肿瘤类型至关重要。磁共振（MR）弹性成像可能提供一种非侵入性方法来评估纵隔肿瘤亚型的分类。
评估MR弹性成像在前纵隔肿块中的应用，并表征不同亚型肿瘤的力学特性。
前瞻性研究。
189例经组织病理学确诊的前纵隔肿瘤（AMT）患者（62例胸腺瘤、53例胸腺癌、57例淋巴瘤和17例生殖细胞肿瘤）。
场强/序列：3.0 T时基于梯度回波的二维MR弹性成像序列和扩散加权成像（DWI）序列。
分别使用MR弹性成像衍生的弹性图和DWI衍生的ADC图测量AMT中的硬度和表观扩散系数（ADC）。本研究的目的是确定MR弹性成像是否能区分ATM的组织学亚型。
单因素方差分析（ANOVA）、双因素方差分析、Pearson线性相关系数（r）、受试者操作特征（ROC）曲线分析；P < 0.05被认为具有统计学意义。
淋巴瘤的硬度显著低于其他AMT（4.0±0.63 kPa对4.8±1.39 kPa）。胸腺癌的平均硬度显著高于其他AMT（5.6±1.41 kPa对4.2±0.94 kPa）。使用5.0 kPa的临界值，ROC分析显示淋巴瘤可与其他AMT区分，准确率为59%，敏感性为97%，特异性为38%。使用5.1 kPa 的临界值，胸腺癌可与其他AMT区分，准确率为84%，敏感性为67%，特异性为90%。然而，个别胸腺瘤（4.2±0.71；3.9 - 4.5）、胸腺癌（5.6±1.41；5.0 - 6.1）、淋巴瘤（4.0±0.63；3.8 - 4.2）和生殖细胞肿瘤（4.5±1.79；3.3 - 5.6）的硬度值存在重叠。
MR弹性成像衍生的硬度可用于评估各种组织学类型的AMT。
2级。
