T2WI全域直方图分析鉴别诊断腮腺多形性腺瘤与腺淋巴瘤

Whole-lesion histogram analysis of T2WI in identification of parotid gland pleomorphic adenoma from adenolymphoma

目的探讨T2WI全域直方图分析鉴别诊断腮腺多形性腺瘤和腺淋巴瘤的价值。方法回顾性分析经手术病理证实的68例腮腺肿瘤患者的资料,其中多形性腺瘤35例(多形性腺瘤组)、腺淋巴瘤33例(腺淋巴瘤组)。术前行常规MR扫描,应用MaZda软件于轴位T2WI上肿瘤所有层面沿肿瘤边界勾画ROI,行直方图分析,所获参数包括平均值、方差、偏度、峰度和第1、10、50、90、99百分位数,比较2组间的差异,并绘制ROC曲线,评价各参数鉴别诊断2种肿瘤的价值。结果多形性腺瘤组与腺淋巴瘤组间平均值、方差、偏度、峰度和第10、50、90、99百分位数差异有统计学意义(P均<0.05),ROC曲线下面积分别为0.769、0.757、0.771、0.776、0.661、0.780、0.781、0.738(P均<0.05)。以平均值鉴别2种肿瘤的敏感度、特异度分别为82.86%和72.73%;方差为72.73%和74.29%;偏度为84.85%和65.71%;峰度为69.70%和74.29%;第10百分位数为60.61%和82.86%;第50百分位数为72.73%和82.86%;第90百分位数为60.61%和94.29%;第99百分位数为85.71%和57.58%。结论 T2WI全域直方图分析鉴别腮腺多形性腺瘤和腺淋巴瘤具有较高价值,其中第50、90百分位数的诊断效能较高。

Objective To investigate the value of whole-lesion histogram analysis derived from T2WI in differential diagnosis of parotid gland pleomorphic adenoma from adenolymphoma.Methods Data of 68 patients with parotid tumors confirmed by operation and pathology were retrospectively analyzed,including 35 with pleomorphic adenoma(polymorphic adenoma group)and 33 with adenolymphoma(adenolymphoma group).Routine MR scanning was performed before operation.MaZda software was used to delineate the ROI along tumor boundary at all slices on axial T2WI,and histogram analysis was performed to obtain parameters including mean,variance,skewness,kurtosis,and the 1 st,10 th,50 th,90 th and 99 th percentiles.The parameters were compared between the two groups,and the ROC curve was drawn to explore the value of each parameter in differential diagnosis of the two tumors.Results The mean,variance,skewness,kurtosis,and the 10 th,50 th,90 th and 99 th percentiles were statistically significant between the pleomorphic adenoma group and the adenolymphoma group(all P<0.05),with the areas under ROC curve of 0.769,0.757,0.771,0.776,0.661,0.780,0.781 and 0.738(all P<0.05),respectively.The sensitivity and the specificity of the mean in diagnosis of pleomorphic adenoma from adenolymphoma out were 82.86%and 72.73%,of the variance were 72.73%and 74.29%,of the skewness were 84.85%and 65.71%,of the kurtosis were 69.70%and 74.29%,of the 10 th percentile were 60.61%and 82.86%,of the 50 th percentile were 72.73%and 82.86%,of the 90 th percentile were 60.61%and 94.29%,of the 99 th percentile were 85.71%and 57.58%.Conclusion Whole-lesion histogram analysis of T2 WI has great value in distinguishing parotid pleomorphic adenoma from adenolymphoma,and the 50 th and 90 th percentiles have high diagnostic efficacy.