3.0T磁共振扩散峰度成像在口腔颌面部肿瘤中的鉴别诊断价值

The Value of 3.0T MRI Diffusion Kurtosis Imaging in Differential Diagnosis of Oral and Maxillofacial Tumors

目的探讨3.0 T磁共振扩散峰度成像(DKI)在口腔颌面部肿瘤中的鉴别诊断价值。方法搜集2017年11月至2020年1月术前接受DKI检查的口腔颌面部肿瘤患者74例。Spearman相关分析计算平均扩散系数(ADC)、校正过的平均扩散系数(D_(app))、平均峰度系数(K_(app))三者相关性。根据病理结果将其分为良性肿瘤组和恶性肿瘤组,比较两组ADC、D_(app)、K_(app)的差异。进一步将口腔颌面部肿瘤分为五个亚组,包括多形性腺瘤组、恶性涎腺肿瘤组、鳞状细胞癌组、腺淋巴瘤组、淋巴瘤组,比较各亚组DKI各参数差异。结果ADC与D_(app)呈正相关(P<0.001)、ADC与K_(app)呈负相关(P<0.001),D_(app)与K_(app)呈负相关(P<0.001)。良性肿瘤组44例,均为单发,恶性肿瘤组30例,共35个病灶。两组肿瘤ADC、D_(app)、K_(app)均存在显著性差异(P<0.001),分别以ADC=0.91×10^(-3) mm^(2)/s、MD=1.44×10^(-3) mm^(2)/s、MK=0.80作为鉴别两组的最佳诊断阈值,诊断准确率分别为77.22%、75.95%、77.22%,三者ROC曲线下面积差异无统计学意义(P>0.05)。ADC、D_(app)、K_(app)在各亚组之间的差异存在统计学意义(P<0.001),组内两两比较结果中K_(app)鉴别的亚组数目明显多于D_(app)、ADC。结论DKI在鉴别口腔颌面部良恶性肿瘤以及各亚组中有较好的应用价值。

Objective To explore the differential diagnostic value of 3.0 T MRI diffusion kurtosis imaging(DKI)in oral and maxillofacial tumors.Methods A total of 74 patients with oral and maxillofacial tumors who underwent preoperative DKI examinations from November 2017 to January 2020 were collected.We calculated the correlation between mean diffusion coefficient(ADC),corrected mean diffusion coefficient(D_(app)),and mean kurtosis coefficient(K_(app))by using Spearman correlation analysis.Oral and maxillofacial tumors were divided into benign and malignant tumor groups according to pathological findings,and the differences of ADC,D_(app),and K_(app) between the two groups were compared.The oral and maxillofacial tumors were further divided into five subgroups,including pleomorphic adenoma group,malignant salivary gland tumor group,squamous cell carcinoma group,adenolymphomagroup,and lymphoma group.We compared the differences of each parameter of DKI in each subgroup.Results ADC was positively correlated with D_(app)(P<0.001),ADC was inversely correlated with K_(app)(P<0.001),and D_(app) was inversely correlated with K_(app)(P<0.001).There were 44 patients with 44 benign tumors and 30 patients with 35 malignant tumors.There were significant differences in ADC,D_(app),and K_(app) of the two groups(P<0.001).ADC=0.91×10^(-3)mm^(2)/s,D_(app)=1.44×10^(-3)mm^(2)/s,and K_(app)=0.80 were used as the best diagnostic thresholds to discriminate the two groups,respectively,and the diagnostic accuracy was 77.22%,75.95%,and 77.22%.The differences of area under the ROC curve did not reach statistical significance for the three parameters(P>0.05).The differences of ADC,D_(app),and K_(app) were statistically significant among the subgroups(P<0.001),and the number of subgroups identified by K_(app) were significantly more than that of D_(app) and ADC in the results of the subgroup comparison.Conclusion DKI is useful in differentiating benign and malignant oral and maxillofacial tumors as well as in multiple subgroups.