Gamaleldin Omneya, Iannella Giannicola, Cavalcanti Luca, Desouky Salaheldin, Shama Sherif, Gamaleldin Amel, Elwany Yasmine, Magliulo Giuseppe, Greco Antonio, Pace Annalisa, Virgilio Armando De, Maniaci Antonino, Lavalle Salvatore, Messineo Daniela, Bahgat Ahmed
Department of Radiodiagnosis, Faculty of Medicine, University of Alexandria, Alexandria 21111, Egypt.
Department of Sensory Organs, "Sapienza" University of Rome, 00184 Roma, Italy.
J Imaging. 2024 Oct 18;10(10):257. doi: 10.3390/jimaging10100257.
The most difficult diagnostic challenge in neck imaging is the differentiation between benign and malignant neoplasms. The purpose of this work was to study the role of the ADC (apparent diffusion coefficient) value in discriminating benign from malignant neck neoplastic lesions. The study was conducted on 53 patients with different neck pathologies (35 malignant and 18 benign/inflammatory). In all of the subjects, conventional MRI (magnetic resonance imaging) sequences were performed apart from DWI (diffusion-weighted imaging). The mean ADC values in the benign and malignant groups were compared using the Mann-Whitney test. The ADCs of malignant lesions (mean 0.86 ± 0.28) were significantly lower than the benign lesions (mean 1.43 ± 0.57), and the mean ADC values of the inflammatory lesions (1.19 ± 0.75) were significantly lower than those of the benign lesions. The cutoff value of 1.1 mm/s effectively differentiated benign and malignant lesions with a 97.14% sensitivity, a 77.78% specificity, and an 86.2% accuracy. There were also statistically significant differences between the ADC values of different malignant tumors of the neck (, 0.001). NHL (0.59 ± 0.09) revealed significantly lower ADC values than SCC (0.93 ± 0.15). An ADC cutoff point of 0.7 mm/s was the best for differentiating NHL (non-Hodgkin lymphoma) from SCC (squamous cell carcinoma); it provided a diagnostic ability of 100.0% sensitivity and 89.47% specificity. ADC mapping may be an effective MRI tool for the differentiation of benign and inflammatory lesions from malignant tumors in the neck.
颈部成像中最具挑战性的诊断难题是区分良性和恶性肿瘤。本研究的目的是探讨表观扩散系数（ADC）值在鉴别颈部良性与恶性肿瘤性病变中的作用。该研究对53例患有不同颈部疾病的患者进行（35例恶性病变和18例良性/炎性病变）。所有受试者均进行了常规磁共振成像（MRI）序列检查，未进行扩散加权成像（DWI）。使用Mann-Whitney检验比较良性和恶性组的平均ADC值。恶性病变的ADC值（平均0.86±0.28）显著低于良性病变（平均1.43±0.57），炎性病变的平均ADC值（1.19±0.75）显著低于良性病变。1.1mm/s的截断值能有效区分良性和恶性病变，灵敏度为97.14%，特异性为77.78%，准确率为86.2%。颈部不同恶性肿瘤的ADC值之间也存在统计学显著差异（P<0.001）。非霍奇金淋巴瘤（NHL，0.59±0.09）的ADC值显著低于鳞状细胞癌（SCC，0.93±0.15）。0.7mm/s的ADC截断点最适合区分NHL（非霍奇金淋巴瘤）和SCC（鳞状细胞癌）；其诊断能力为灵敏度100.0%，特异性89.47%。ADC图可能是一种有效的MRI工具，用于区分颈部的良性和炎性病变与恶性肿瘤。
