■准确区分多形性腺瘤(PA)和Warthin肿瘤(WT)有利于它们各自的治疗。术前磁共振成像(MRI)由于其出色的软组织对比度,可以提供有价值的信息。本研究探讨了半定量对比增强MRI参数在PA和WT鉴别诊断中的价值。
■来自106名患者的数据,对62例PA和44例WT(经组织病理学证实)进行回顾性和连续分析。基于平均值的肿瘤与脊髓对比比(TSc-CR),最大值,和最小信号强度(T1-平均TSc-CR,T1-maxTSc-CR,和T1-minTSc-CR,分别)在早期和延迟阶段,在对比增强的T1加权图像上计算作为半定量参数,然后比较PA和WT。使用受试者工作特征(ROC)曲线分析和曲线下面积(AUC)来确定这些参数在PA与WT的鉴别诊断中的性能。
■除了早期的T1-minTSc-CR,PA和WT之间的所有半定量MRI参数均存在显着差异(均P<0.05)。T1-maxTSc-CR显示出较高的敏感性{70.45%[95%置信区间(CI):0.548-0.832]}和特异性[70.97%(95%CI:0.581-0.818)],并且当使用1.89的截止值时,在早期阶段具有较高的AUC[0.707(95%CI:0.610-0.791)]。T1-maxTSc-CR显示更高的灵敏度[88.64%(95%CI:0.754-0.962)],特异性[72.58%(95%CI:0.598-0.831)],和AUC[0.854(95%CI:0.772-0.915)]在延迟阶段时使用2.33的截止值。敏感性,特异性,AUC改善至90.91%(95%CI:0.783-0.975),93.55%(95%CI:0.843-0.982),和0.960(95%CI:0.903-0.988),分别,在早期和延迟阶段组合所有半定量参数后。两位放射科医生在TSc-CRs上观察者间有很好的一致性[所有类间相关系数(ICC)>0.75]。
■使用TSc-CR的半定量参数在区分PA和WT方面是有价值的,这些参数的组合可以提高鉴别诊断效率。
UNASSIGNED: Accurately distinguishing between
pleomorphic adenoma (PA) and Warthin tumor (WT) is beneficial for their respective management. Preoperative magnetic resonance imaging (MRI) can provide valuable information due to its excellent soft tissue contrast. This study explored the value of semiquantitative contrast-enhanced MRI parameters in the differential diagnosis of PA and WT.
UNASSIGNED: Data from 106 patients, 62 with PA and 44 with WT (confirmed by histopathology) were retrospectively and consecutively analyzed. The tumor-to-spinal cord contrast ratios (TSc-CR) based on the mean, maximum, and minimum signal intensity (T1-mean TSc-CR, T1-max TSc-CR, and T1-min TSc-CR, respectively) in the early and delayed phases were calculated on contrast-enhanced T1-weighted images as semiquantitative parameters, and then compared between PA and WT. Receiver operating characteristic (ROC) curve analysis and areas under the curve (AUCs) were used to determine the performance of these parameters in the differential diagnosis of PA from WT.
UNASSIGNED: Except T1-min TSc-CR in the early phase, all semiquantitative MRI parameters differed significantly between PA and WT (all P<0.05). T1-max TSc-CR showed higher sensitivity {70.45% [95% confidence interval (CI): 0.548-0.832]} and specificity [70.97% (95% CI: 0.581-0.818)] and had a higher AUC [0.707 (95% CI: 0.610-0.791)] in the early phase when using a cutoff value of 1.89. T1-max TSc-CR showed higher sensitivity [88.64% (95% CI: 0.754-0.962)], specificity [72.58% (95% CI: 0.598-0.831)], and AUC [0.854 (95% CI: 0.772-0.915)] in the delayed phase when using a cutoff value of 2.33. The sensitivity, specificity, and AUC were improved to 90.91% (95% CI: 0.783-0.975), 93.55% (95% CI: 0.843-0.982), and 0.960 (95% CI: 0.903-0.988), respectively, after combination of all semiquantitative parameters in the early and delayed phases. The two radiologists had excellent interobserver agreement on TSc-CRs [all interclass correlation coefficient (ICC) >0.75].
UNASSIGNED: Semiquantitative parameters using TSc-CR are valuable in distinguishing PA from WT, and a combination of these parameters can improve the differential diagnostic efficiency.