3.0T MR动脉自旋标记对腮腺肿瘤的鉴别诊断价值

Preliminary study of 3.0T MR arterial spin labeling in the diagnosis of parotid gland tumors

目的:初步探讨3.0T磁共振动脉自旋标记技术(ASL)对腮腺肿瘤的鉴别诊断价值。方法:前瞻性搜集2017年3月-2020年1月因腮腺肿物于本院就诊及治疗的患者作为研究对象,所有研究对象均行常规MR平扫及ASL扫描,测量ASL序列图像上肿瘤组织的肿瘤血流量(TBF),并将计算出的标准化肿瘤血流量(nTBF)与病理结果进行对比分析。结果:本研究总共纳入45例经术后病理证实的腮腺肿瘤患者。其中良性肿瘤28例,包括腺淋巴瘤14例,多形性腺瘤14例;恶性肿瘤共17例。测量并经计算得出腺淋巴瘤、多形性腺瘤、恶性腮腺肿瘤的nTBF分别为:3.71±1.65、0.89±0.25、1.55±0.60。腺淋巴瘤的nTBF明显高于多形性腺瘤(P<0.01)和恶性肿瘤(P<0.01),但是多形性腺瘤和恶性肿瘤的nTBF差异无统计学意义(P=0.073)。ASL能将腮腺腺淋巴瘤从多形性腺瘤及恶性肿瘤中鉴别出来,但是无法鉴别多形性腺瘤与恶性肿瘤。ASL诊断腮腺腺淋巴瘤的ROC曲线下面积为0.935,nTBF的诊断阈值为2.03,诊断腺淋巴瘤的敏感度和特异度分别为92.9%、93.5%。结论:3.0T MR ASL技术可以无创地、定量地评价腮腺肿瘤的TBF,并对腺淋巴瘤的诊断和鉴别诊断具有较高的价值。

Objective:To investigate the value of arterial spin labeling(ASL)of 3.0T magnetic resonance imaging(MRI)in differential diagnosis of parotid tumors.Methods:Patients with parotid gland mass treated in our hospital from March 2017 to January 2020 were prospectively collected as the research subjects.All patients underwent conventional MR plain scan and ASL scan.And tumor blood flow(TBF)of tumor tissue on ASL sequence images was measured.Then the Normalized tumor blood flow(nTBF)was compared with pathological results.Results:A total of 45 patients with parotid gland tumors confirmed by postoperative pathology were enrolled in this study,including 28 benign tumors(14 Warthin's tumors,14 pleomorphic adenomas)and 17 malignant tumors.The nTBF of Warthin tumors,pleomorphic adenomas and malignant parotid gland tumors were 3.71±1.65,0.89±0.25,1.55±0.60,respectively.The nTBF of Warthin tumors was significantly higher than pleomorphic adenomas and malignant parotid gland tumors(P<0.01).However,there was no statistically significant difference in NTBF between pleomorphic adenomas and malignant tumors(P=0.073).ASL can distinguish Warthin tumors from pleomorphic adenomas and malignant tumors,but it cannot distinguish pleomorphic adenomas and malignant tumors.The area under the ROC curve of ASL in the diagnosis of Warthin's tumors was 0.935,and the diagnostic threshold of nTBF was 2.03.The sensitivity and specificity of Warthin's tumors were 92.9%and 93.5%,respectively.Conclusion:3.0T MR ASL technique could evaluate TBF of parotid gland tumors noninvasively and quantitatively,and had high value in the diagnosis and differential diagnosis of Warthin tumors.