摘要
目的评估磁共振扩散加权成像(DWI)ADC值定量在鉴别良恶性胆囊肿物的价值。方法回顾性收集2020年6月—2024年6月经手术病理证实的胆囊肿物61例,所有患者均行3.0 T磁共振检查(含DWI序列),其中胆囊恶性肿瘤37例和良性肿物24例。测量胆囊肿物实性部分的表观扩散系数(ADC)值,并计算其T1WI、T2WI信号与肌肉组织的信号强度比(SI-RT1、SI-RT2)。比较两组间各参数的差异,采用受试者工作特征(ROC)曲线分析诊断效能。结果恶性肿物DWI上14例表现为高信号,23例表现为很高信号;良性肿物DWI上11例为等信号,13例为高信号,两组间差异有统计学意义(P<0.001)。胆囊恶性肿物ADC值[(1.079±0.20)×10^(-3) mm^(2)/s]明显低于良性肿物[(1.93±0.31)×10^(-3) mm^(2)/s](P<0.001);恶性肿物SI-RT2(3.54±1.14)显著低于良性肿物(5.18±1.41)(P<0.001)。ADC值鉴别良恶性胆囊肿物的诊断界值为1.41×10^(-3) mm^(2)/s,敏感度和特异度分别为97.3%、100%,曲线下面积(AUC)为0.998。SI-RT2鉴别良恶性胆囊肿物的诊断界值为4.34,敏感度和特异度分别为75.7%、75%,AUC为0.812。结论磁共振成像ADC定量可用于鉴别胆囊良恶性肿物,具有很高的诊断效能。
Objective To assess the value of quantitative analysis of diffusion-weighted MRI(DWI)in differentiating benign and malignant gallbladder tumors.Methods The clinical and MR imaging data of 61 patients with pathologically confirmed malignant(37)and benign(24)gallbladder tumors from June 2020 to June 2024 were retrospectively collected.Quantitative parameters included the ratio of signal intensities(SI)on T1-(SI-RT1)and T2-(SI-RT2)weighted images between the solid component of the lesion and muscle tissue as well as the apparent diffusion coefficient(ADC)value of the solid component of gallbladder tumors.The parameters between the malignant and benign gallbladder tumors were compared.Receiver operating characteristic(ROC)curve analysis was performed to determine the cut-off value and evaluate the diagnostic efficacy.Results High(14)and very high(23)SI on DWI in malignancy were significantly(P<0.001)greater than the equal(11)and high(13)SI on DWI in benign tumors.The mean ADC value of the malignancy[(1.079±0.20)×10^(-3) mm^(2)/s]was significantly(P<0.001)lower than that of benign tumors[(1.93±0.31)×10^(-3) mm^(2)/s].The SI-RT2 of the malignancy(3.54±1.14)was significantly(P<0.001)lower than that of benign tumors(5.18±1.41).The area under the ROC curve(AUC)of the ADC value for differentiating benign and malignant gallbladder tumors was 0.998 with 97.3% sensitivity and 100% specificity at a cut-off ADC value of 1.41×10^(-3) mm^(2)/s.The AUC of the SI-RT2 for differentiating benign and malignant gallbladder tumors was 0.812 with 75.7% sensitivity and 75% specificity at a cut-off ADC value of 4.34.The diagnostic performance of ADC value was significantly higher than that of SI-RT2(P=0.001).Conclusion Quantitative analysis of ADC has high diagnostic efficacy for differentiating benign and malignant gallbladder tumors.
作者
云惟健
王欣怡
伏文皓
唐广磊
关键
李畅
YUN Weijian;WANG Xinyi;FU Wenhao;TANG Gaunglei;GUAN Jian;LI Chang(Department of Radiology,The First Affiliated Hospital,Sun Yat-Sen University,Guangdong 510080,China)
出处
《影像诊断与介入放射学》
2025年第4期241-246,共6页
Diagnostic Imaging & Interventional Radiology
基金
广东省基础与应用基础研究基金(2024A1515012098)
广州市科技计划项目(2023A04J2229)。
关键词
磁共振成像
表观扩散系数
定量分析
胆囊肿瘤
Magnetic resonance imaging
Apparent diffusion coefficient
Quantitative analysis
Gallbladder tumor
