多路敏感编码扩散加权成像直方图鉴别鼻咽癌和鼻咽淋巴瘤的价值

Value of multiplexed sensitivity encoding diffusion-weighted imaging histogram analysis in distinguishing nasopharyngeal carcinoma from nasopharyngeal lymphoma

目的探讨多路敏感编码扩散加权成像(Multiplexed sensitivity encoding diffusion-weighted imaging,MUSEDWI)直方图鉴别鼻咽癌和鼻咽淋巴瘤的可行性。方法回顾性分析2020年10月~2022年12经病理证实为鼻咽部肿瘤患者82例。所有患者行MUSE-DWI检查。依据病理分为鼻咽癌组(51例)和鼻咽淋巴瘤组(31例),在肿瘤最大截面的表观扩散系数(ADC,b=1000mm2/s)图上手动勾画感兴趣区,提取直方图参数,包括均值、标准差、偏度以及峰度。统计比较鼻咽癌组与鼻咽淋巴瘤组在各直方图参数间的差异。绘制受试者工作特征(ROC)曲线,比较有差异参数的曲线下面积(AUC),以此来评价不同参数对鼻咽癌和鼻咽淋巴瘤的鉴别能力。结果直方图各个参数均有较好的组内及组间一致性,鼻咽癌组的均值以及标准差均明显高于鼻咽淋巴瘤组(P<0.05),其中均值的AUC值最大(AUC=0.805),阈值为754.95×10-3mm2/s,其鉴别的敏感度和特异度分别为76.5%和74.2%,两组的偏度及峰度差异无统计学意义(P>0.05)。结论基于MUSE-DWI直方图的均值和标准差具有较好的再现性,可为临床鉴别鼻咽癌和鼻咽淋巴瘤提供新的无创、定量方法。

Objective To investigate the diagnostic value of histogram analysis based on multiplexed sensitivity encoding diffusion-weighted imaging(MUSE-DWI)for distinguishing between nasopharyngeal carcinoma(NPC)and nasopharyngeal lymphoma(NPL).Methods A retrospective analysis was conducted on 82 patients with pathologically confirmed nasopharyngeal tumors from Oct 2020 to Dec 2022.All patients underwent MUSE-DWI examinations.Based on pathology,the patients were divided into NPC group(51 cases)and NPL group(31 cases).Regions of interest were manually drawn on the apparent diffusion coefficient(ADC,b=1000mm2/s)maps at the maximum crosssectional area of the tumors,and histogram parameters including mean,standard deviation,skewness,and kurtosis were extracted.The differences in the histogram parameters between the NPC and NPL groups were statistically analyzed.Receiver operating characteristic(ROC)curve was plotted,and the area under the ROC curve(AUC)was compared to evaluate the discriminative ability of different parameters for distinguishing between NPC and NPL.Results All histogram parameters had good intra and interclass correlation coefficient.The differences in mean and standard deviation between the NPC and NPL groups were statistically significant(P<0.05).The mean had the highest AUC value as 0.805,with a threshold of 754.95×10-3mm2/s.The corresponding sensitivity and specificity were 76.5%and 74.2%,respectively.There was no significant difference in skewness and kurtosis between the two groups(P>0.05).Conclusion The mean and standard deviation based on MUSE-DWI histogram have good reproducibility,which can provide a new non-invasive and quantitative method for clinical discrimination between NPC and NPL.