动态增强MRI直方图鉴别胸腺癌与胸腺淋巴瘤

Histogram analysis of dynamic contrast-enhanced magnetic resonance imaging for differentiating thymic carcinomas and thymic lymphomas

目的探讨DCE-MRI直方图在鉴别诊断胸腺癌和胸腺淋巴瘤中的价值。方法回顾性分析经病理证实的21例胸腺癌和21例胸腺淋巴瘤患者。所有患者均行3 T DCE-MRI检查,动态增强采用StarVIBE序列行35期扫描。对两组的临床资料和直方图参数进行分析。多因素逐步逻辑回归分析筛选参数,并用ROC曲线确定诊断效能。结果胸腺癌组Kep的P10、平均值、中位数、P90、偏度和峰度分别为0.465±0.132、0.781±0.219、0.743±0.194、1.125±0.330、2.701±3.769、0.901±0.752;胸腺淋巴瘤组分别为0.260±0.198、0.585±0.302、0.539±0.283、0.816±0.418、10.947±17.459、1.807±1.772,两组间参数差异均有统计学意义。在Ve参数中,胸腺癌组P10、平均值、中位数、P90分别为0.277±0.168、0.484±0.248、0.473±0.277、0.717±0.202;胸腺淋巴瘤组分别为0.129±0.136、0.327±0.209、0.302±0.181、0.410±0.210,两组间参数存在差异。两组Ktrans直方图参数无统计学差异(P值大于0.05)。Ve-P90以及Kep-P10的AUC分别为0.844和0.828,敏感度和特异度分别为85.7%、66.7%和85.7%、81.0%。结论DCE-MRI定量参数直方图分析有助于鉴别胸腺癌和胸腺淋巴瘤,Ve-P90和Kep-P10诊断效能较高。

Objective To investigate the role of histogram analysis of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)quantitative parameters in the differentiation of thymic carcinomas and thymic lymphomas.Methods The DCE-MRI of 42 patients with histologically confirmed thymic carcinomas(21)and thymic lymphomas(21)was analyzed retrospectively.All patients underwent 3T DCE-MRI with StarVIBE sequence.The clinical data and histogram parameters of the two groups were analyzed.Multi-factor stepwise logical regression analysis was used to screen the parameters,and the area under receiver operating characteristic curve(AUC)was calculated to determine the diagnostic efficiency of the parameters.Results There was significant difference(P<0.05)in Kep parameters between thymic carcinoma and lymphoma with P10(0.465±0.132,0.260±0.198),mean(0.781±0.219,0.585±0.302),median(0.743±0.194,0.539±0.283),P90(1.125±0.330,0.816±0.418),skewness(2.701±3.769,10.947±17.459),and kurtosis(0.901±0.752,1.807±1.772).There was also significant difference(P<0.05)in Ve parameters between thymic carcinoma and lymphoma with P10(0.277±0.168,0.129±0.136),mean(0.484±0.248,0.327±0.209),median(0.473±0.277,0.302±0.181),and P90(0.717±0.202,0.410±0.210).There was no significant difference(P>0.05)in Ktrans histogram parameters between the two groups.Ve-P90 had 0.844 AUC,85.7%sensitivity,and 66.7%specificity whereas Kep-P10 had 0.828 AUC,85.7%sensitivity,and 81.0%specificity.Conclusion Histogram analysis of DCE-MRI quantitative parameters is helpful to differentiate thymic carcinoma from thymic lymphoma.Ve-P90 and Kep-P10 have higher diagnostic efficacy in differentiating the two malignancies.