基于体素内不相干运动的扩散加权成像在涎腺肿瘤中的初步应用

Preliminary Study of Intravoxel Incoherent Motion Diffusion-Weighted Imaging of Salivary Gland Tumors

目的评估体素内不相干运动扩散加权成像(IVIM DWI)参数在不同病理类型涎腺肿瘤间的差异性。方法选择临床怀疑涎腺肿瘤患者55例,男32例,女23例,中位年龄51岁。患者均行3.0 T MR扫描,IVIM采用11个b值(0、10、20、30、50、80、100、200、300、400、800 s/mm2)。对涎腺肿瘤基于IVIM理论基础的灌注和扩散成像进行评估。采用非参数Mann-Whitney检验法比较不同病理类型涎腺肿瘤间IVIM参数值D值、D*值及值的差异。结果 55例患者中完成IVIM DWI检查并纳入统计学分析者共47例,包括45个良性肿瘤(多形性腺瘤23个,腺淋巴瘤15个,肌上皮瘤4个,基底细胞腺瘤2个,蔓状血管瘤1个)和5个恶性肿瘤(腺泡细胞癌2个,黏液表皮样癌1个,腺样囊性癌1个,转移性黑色素瘤1个),45个发生于腮腺,5个发生于颌下腺。腺淋巴瘤的D值显著低于其他良性肿瘤,多形性腺瘤、肌上皮瘤及基底细胞腺瘤间D值差异无统计学意义,D*值在上述4种良性上皮型肿瘤中差异均有统计学意义。结论不同病理类型涎腺肿瘤的IVIM参数具有差异性,IVIM DWI对区分涎腺肿瘤的病理亚型具有较大的潜力。

Objective To prospectively determine the value of intravoxel incoherent motion（IVIM） parameters（pure diffusion coefficient,D,perfusion-related incoherent microcirculation,D＊ and microvascular volume fraction,？）in differentiating various histological types of primary salivary gland tumors.Methods Fifty-five consecutive patients（32 men,23 women; median age,51 years） suspected salivary gland tumors were examined on a 3.0T MR scanner.DW imaging was performed by using a single-shot echo-planar sequence with 11 b-values（0、10、20、30、50、80、100、200、300、400、800 s / mm2）.The perfusion and diffusion of salivary gland tumors were assessed on the basis of the IVIM theory.The Mann Whitney test were used to assess difference of the IVIM parameters in various histological types of primary salivary gland tumors.Results Successful IVIM DWI were acquired in 47 patients with a total of 45 benign salivary gland tumors（23 pleomorphic adenomas,15 Warthin tumors,4 myoepitheliomas,2 basal cell adenomas,1 cirsoid hemangioma）and 5 malignant tumors（2 acinic cell carcinomas,1 mucoepidermoid carcinoma,1 adenoid cystic carcinoma,1 metastatic tumor）.Tumors were located in parotid gland（45 cases） and submandibular gland（5 cases）.The D values of Warthin tumors were significantly different from those of other benign tumors.Differences were significant of the D＊ values among Warthin tumors,pleomorphic adenomas,myoepitheliomas and basal cell adenomas.Conclusion Different histological types of salivary gland tumors have different IVIM parameters.IVIM DWI may have the potential to differentiate the histological subtypes of salivary gland tumors.