ADC直方图鉴别鼻咽癌和鼻咽部淋巴瘤的价值
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摘要
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.
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.
引文
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12 Suo S,Zhang K,Cao M,et al.Characterization of breast masses as benign or malignant at 3.0T MRI with whole-lesion histogram analysis of the apparent diffusion coefficient[J].J Magn Reson Imaging,2016,43:894-902.
13 Donati OF,Mazaheri Y,Afaq A,et al.Prostate cancer aggressiveness:assessment with whole-lesion histogram analysis of the apparent diffusion coefficient[J].Radiology,2014,271:143-152.
2 Stokken J,Manz RM,Flagg A,et al.Synchronous occurrence of nasopharyngeal carcinoma and Hodgkin lymphoma[J].Int J Pediatr Otorhinolaryngol,2014,78:154-156.
3宋承汝,程敬亮,孙梦恬,等.扩散加权成像鉴别诊断鼻咽癌和鼻咽部淋巴瘤[J].中国医学影像技术,2014,30:982-985.
4 Liu XW,Xie CM,Mo YX,et al.Magnetic resonance imaging features of nasopharyngeal carcinoma and nasopharyngeal non-Hodgkin's lymphoma:are there differences?[J].Eur J Radiol,2012,81:1146-1154.
5 Fong D,Bhatia KS,Yeung D,et al.Diagnostic accuracy of diffusionweighted MR imaging for nasopharyngeal carcinoma,head and neck lymphoma and squamous cell carcinoma at the primary site[J].Oral Oncol,2010,46:603-606.
6 Woo S,Cho JY,Kim SY,et al.Histogram analysis of apparent diffusion coefficient map of diffusion-weighted MRI in endometrial cancer:a preliminary correlation study with histological grade[J].Acta Radiol,2014,55:1270-1277.
7 Yu XP,Hou J,Li FP,et al.Quantitative dynamic contrast-enhanced and diffusion-weighted MRI for differentiation between nasopharyngeal carcinoma and lymphoma at the primary site[J].Dentomaxillofac Radiol,2016,45:20150317.
8胡斌,徐克,张立娜,等.基于表观扩散系数图像的影像组学模型对MRI乳腺影像报告与数据系统4类病变良恶性的鉴别诊断价值[J].中华放射学杂志,2017,51:922-925.
9 Xu XQ,Ma G,Wang YJ,et al.Histogram analysis of diffusion kurtosis imaging of nasopharyngeal carcinoma:Correlation between quantitative parameters and clinical stage[J].Oncotarget,2017,8:47230-47238.
10 Cho KS,Kang DW,Kim HJ,et al.Differential diagnosis of primary nasopharyngeal lymphoma and nasopharyngeal carcinoma focusing on CT,MRI,and PET/CT[J].Otolaryngol Head Neck Surg,2012,146:574-578.
11林宇宁,李辉,陈自谦,等.采用MR扩散加权成像表观扩散系数值直方图诊断ⅠB期宫颈癌的价值[J].中华放射学杂志,2015,49:349-353.
12 Suo S,Zhang K,Cao M,et al.Characterization of breast masses as benign or malignant at 3.0T MRI with whole-lesion histogram analysis of the apparent diffusion coefficient[J].J Magn Reson Imaging,2016,43:894-902.
13 Donati OF,Mazaheri Y,Afaq A,et al.Prostate cancer aggressiveness:assessment with whole-lesion histogram analysis of the apparent diffusion coefficient[J].Radiology,2014,271:143-152.