酰胺质子转移成像对腮腺良恶性肿瘤的鉴别价值

Differential Value of Amide Proton Transfer Imaging for Benign and Malignant Tumors of the Parotid Gland

目的评估酰胺质子转移(amide proton transfer,APT)成像在鉴别腮腺良恶性肿瘤中的价值。方法回顾性分析2020年1月-2022年12月我院接受MRI检测并经组织病理学证实的直径≥2cm的腮腺实体瘤患者资料。其中良性肿瘤63例,恶性肿瘤25例。在APT图像上获得平均APT信号强度(signal intensity,SI)。比较良、恶性腮腺肿瘤的平均APT SI值差异。使用受者操作特征曲线(receiver operating characteristic,ROC)分析APT SI值鉴别诊断腮腺良恶性肿瘤的诊断性能。结果良性肿瘤的平均APT SI值为2.23±0.80%,恶性肿瘤的平均APT SI值为2.99±0.99%(t=3.751,P=0.000)。ROC曲线分析显示使用APT SI值鉴别良、恶性肿瘤的最佳阈值为2.41,此时的曲线下面积为0.78,敏感性、特异性和准确性分别为0.825,0.760和0.807。结论腮腺恶性肿瘤的平均APTSI值高于良性肿瘤,APT成像可作为鉴别腮腺良恶性肿瘤的可靠方法。

Objective To evaluate the value of amide proton transfer(APT)imaging in differentiating benign from malignant tumors of the parotid gland.Methods Patients with solid tumors of the parotid gland≥2 cm in diameter,which were detected by MRI and confirmed by histopathology in our hospital from January 2020 to December 2022,were retrospectively reviewed.Among them,63 patients had benign tumors and 25 patients had malignant tumors.Mean APT signal intensity(SI)was obtained on apt images.Differences in mean APT SI values were compared between benign and malignant parotid tumors.The diagnostic performance of APT SI values for the differential diagnosis of benign and malignant tumors of the parotid glands was analyzed using the receiver operating characteristic curve(ROC).Results the mean APT SI was 2.23±0.80%in benign tumors and 2.99±0.99%in malignant tumors(t=3.751,P=0.000).ROC curve analysis showed that the optimal threshold for discriminating good and malignant tumors using APT SI values was 2.41,at which point the area under the curve was 0.78,and the sensitivity,specificity,and accuracy were 0.825,0.760,and 0.807,respectively.Conclusion The mean APT SI values of parotid malignancies are higher than those of benign tumors,and APT imaging can be used as a reliable method to differentiate benign from malignant tumors of the parotid gland.