增强MRI扫描全域直方图鉴别诊断Warthin’s瘤和腮腺癌的价值

Whole tumor histogram analysis of enhanced MRI in differenting Warthin’s tumor and salivary gland cancer

目的探讨增强MRI扫描全域直方图各参数在Warthin’s瘤和腮腺癌鉴别诊断中的价值。方法腮腺肿瘤患者53例,其中Warthin’s瘤25例,腮腺癌28例,均行增强MRI扫描,图像导出后应用MaZda 4.6软件勾画感兴趣区,并生成全域直方图,比较Warthin’s瘤与腮腺癌患者全域直方图各参数差异,ROC曲线分析全域直方图各参数诊断腮腺癌的价值。结果 Warthin’s瘤患者全域直方图最大值(227.40±16.28)、均值(150.04±15.89)、偏度[0.110(-0.225,0.540)]、第50百分位数(Perc.50%)[(148.40±13.30)%]、Perc.90%[(187.68±22.12)%]、Perc.99%[(228.04±17.05)%]均小于腮腺癌患者[239.00±17.65、168.04±15.66、0.865(0.645,0.937)、(168.89±13.90)%、(206.21±10.48)%、(244.71±8.56)%](P<0.05),区域面积(346.37±21.75)、最小值(92.08±12.69)、变异度(297.73±26.06)、峰宽(448.83±20.16)、Perc.1%[(82.56±12.66)%]、Perc.10%[(111.32±11.25)%]与腮腺癌患者[347.01±18.68、97.96±19.96、298.76±15.77、444.79±29.15、(86.79±10.61)%、(118.68±19.13)%]比较差异无统计学意义(P>0.05);ROC曲线分析结果显示,最大值、均值、偏度、Perc.50%、Perc.90%、Perc.99%分别以235.50、152.50、0.625、156.50%、195.50%、240.50%为最佳截断值,诊断腮腺癌的AUC分别为0.762、0.802、0.862、0.856、0.784、0.826,且偏度、Perc.50%的AUC较大(P<0.05)。结论增强MRI扫描全域直方图可提供更多量化的肿瘤信息特征,且以偏度、Perc.50%在Warthin’s瘤与腮腺癌的鉴别诊断中价值较高。

Objective To investigate the value of whole tumor histogram analysis of enhanced MRI to differenting Warthin’s tumor and salivary gland cancer. Methods Fifty-three patients with salivary gland cancer including 25 patients with Warthin’s tumor and 28 patients with salivary gland cancer underwent enhanced MRI scanning. The region of interest(ROI) was drawn with Mazda 4.6 software for whole tumor histogram analysis. The differences of whole tumor histogram analysis parameters were compared in patients with Warthin’s and salivary gland cancer. ROC was used to analyze the value of these parameters to the differential diagnosis of Warthin’s tumor and salivary gland cancer. Results The maximum(227.40±16.28), mean(150.04±15.89), skewness(0.110(-0.225, 0.540), Perc.50%((148.40±13.30)%), Perc.90%((187.68±22.12)%) and Perc.99%((228.04±17.05)%) in patients with Warthin’s tumor were lower than those in patients with salivary gland cancer(239.00±17.65, 168.04±15.66, 0.865(0.645, 0.937),(168.89±13.90)%,(206.21±10.48)%,(244.71±8.56)%)(P<0.05). The ROI(346.37±21.75 vs. 347.01±18.68), minimum(92.08±12.69 vs. 97.96±19.96), variance(297.73±26.06 vs. 298.76±15.77), kurtosis(448.83±20.16 vs. 444.79±29.15), Perc.1%((82.56±12.66)% vs.(86.79±10.61)%) and Perc.10%((111.32±11.25)% vs.(118.68±19.13)%) showed no significant differences between patients with Warthin’s tumor and salivary gland cancer(P>0.05). When the optimal cut-off value of maximum, mean, skewness, Perc.50%, Perc.90% and Perc.99% was 235.50,152.50,0.625,156.50%,195.50%,240.50%,the AUC was 0.762,0.802,0.862,0.856,0.784 and 0.826,respectively,and the AUCs of skewness and perc.50% were larger(P<0.05).Conclusion Whole tumor histogram analysis of enhanced MRI can provide more quantitative information features.Skewness and Perc.50%have high values in differenting Warthin\s tumor and salivary gland cancer.