ADC直方图鉴别鼻咽癌和鼻咽部淋巴瘤的价值

Value of ADC Histogram in Differentiating Nasopharyngeal Carcinoma from Nasopharyngeal Lymphoma

目的探讨基于表观扩散系数(ADC)图像的直方图对鼻咽癌(NPC)和鼻咽部淋巴瘤(NPL)的鉴别诊断价值。方法回顾性分析2015年6月至2018年3月郑州大学第一附属医院收治的经手术病理证实的79例鼻咽部恶性肿瘤患者的临床资料及MRI图像,其中NPC 45例,鼻咽部非霍奇金淋巴瘤(NPNHL) 34例,患者均行鼻咽部MRI平扫、扩散加权成像(DWI)及动态增强磁共振成像(DCE-MRI)扫描。运用MaZda软件根据所选图像勾画感兴趣区(ROI)并进行直方图分析,对两组肿瘤直方图参数特征进行统计学分析,提取两种肿瘤之间差异具有统计学意义的参数特征并绘制受试者工作特征曲线(ROC)来检验模型的诊断效能。结果 ADC值的平均值、方差、第10、50、90、99百分位数在两组肿瘤间表现出显著差异。ROC曲线分析得出这些参数的敏感度和特异度依次是62.2%和82.4%、88.9%和64.7%、100%和35.3%、80.0%和61.8%、80.0%和55.9%、80.0%和79.4%,曲线下面积(AUC)分别为0.801、0.813、0.731、0.797、0.795、0.838。结论 ADC直方图分析可用于鉴别NPC和NPL。

Objective To assess the utility of texture analysis of ADC maps for the differentiation of nasopharyngeal carcinoma and nasopharyngeal lymphoma.Methods Sevent-nine patients with diagnosis of nasopharyngeal malignant tumors including 45 cases with nasopharyngeal carcinomas and 34 cases with nasopharyngeal non-Hodgkin lymphoma in First Affiliated Hospital of Zhengzhou University from June 2015 to March 2018 were retrospectively enrolled in this study.All the lesions were proved by pathology and examined by MRI scanning,DWI and dynamic contrast enhanced magnetic resonance imaging(DCE-MRI).Drawing the region of interest(ROI)on the selected MRI images and going on histogram analysis,these two steps were all performed by Mazda software.Performed a statistical analysis on the histogram parameters to find out the characteristics of the significant differences between the two groups and ROC were used to describe its efficiency in differential diagnosis.Results Signifcant differences were observed for mean,variance,and 10 th,50 th,90 th,and 99 th percentiles of the ADC values.ROC curve analysis showed that the sensitivity and specificity of these parameters were 62.2%and 82.4%,88.9%and 64.7%,100%and 35.3%,80.0%and 61.8%,80%and 55.9%,80.0%and 79.4%,successively,and the areas under ROC was 0.801,0.813,0.731,0.797,0.795,0.838,respectively.Conclusion The histogram analysis of the ADC maps can be used to identify nasopharyngeal carcinoma and nasopharyngeal lymphoma.