背景:本研究旨在评估动态对比增强磁共振成像(DCE-MRI)和弥散加权成像(DWI)参数在区分鼻窦淋巴瘤和鼻窦癌方面的诊断效能。
方法:42例经组织学证实的鼻腔鼻窦淋巴瘤和52例鼻腔鼻窦癌患者用3.0TMRI扫描仪进行成像。进行了DCE-MRI和DWI,和各种参数,包括时间-强度曲线(TIC)的类型,时间达到顶峰,峰值增强,峰值对比度增强,冲洗率,表观扩散系数(ADC),测量相对ADC。采用二元logistic回归和受试者工作特征(ROC)曲线分析来评估单独和组合指标对鼻窦淋巴瘤和鼻窦癌的诊断能力。
结果:鼻窦淋巴瘤主要表现为II型TIC(n=20),而鼻腔鼻窦癌主要表现为III型TIC(n=23)。除冲洗比(p<0.05)外,所有参数均存在显着差异。ADC值成为单一参数中最可靠的诊断工具。与个别参数相比,DCE-MRI联合参数显示出更好的诊断效能。当组合DCE-MRI和DWI的所有参数时,效率最高(曲线下面积=0.945)。
结论:涉及对比增强动态MRI和DWI的多参数评估在区分鼻窦淋巴瘤和鼻窦癌方面具有相当大的诊断价值。
BACKGROUND: The study aimed to evaluate the diagnostic efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) parameters in distinguishing sinonasal lymphoma from
sinonasal carcinoma.
METHODS: Forty-two participants with histologically confirmed
sinonasal lymphomas and fifty-two cases of
sinonasal carcinoma underwent imaging with a 3.0T MRI scanner. DCE-MRI and DWI were conducted, and various parameters including type of time-intensity curve(TIC), time to peak, peak enhancement, peak contrast enhancement, washout rate, apparent diffusion coefficient (ADC), and relative ADC were measured. Binary logistic regression and receiver operating characteristic (ROC) curve analysis were employed to assess the diagnostic capability of individual and combined indices for differentiating nasal sinus lymphoma from nasal sinus carcinoma.
RESULTS: Sinonasal lymphoma predominantly exhibited type II TIC(n = 20), whereas
sinonasal carcinoma predominantly exhibited type III TIC(n = 23). Significant differences were observed in all parameters except washout ratio (p < 0.05), and ADC value emerged as the most reliable diagnostic tool in single parameter. Combined DCE-MRI parameters demonstrated superior diagnostic efficacy compared to individual parameters, with the highest efficiency (area under curve = 0.945) achieved when combining all parameters of DCE-MRI and DWI.
CONCLUSIONS: Multiparametric evaluation involving contrast-enhanced dynamic MRI and DWI holds considerable diagnostic value in distinguishing sinonasal lymphoma from
sinonasal carcinoma.