MRI动态对比增强定量参数对鉴别头颈部良恶性病变的临床价值OA
Clinical Value of Quantitative Parameters of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Distinguishing Between Benign and Malignant Lesions of the Head and Neck
目的 探讨 MRI 动态对比增强成像(DCE-MRI)定量参数在头颈部良恶性病变鉴别诊断中的临床应用价值.方法 采用回顾性队列研究,纳入经病理证实的79 例头颈部占位性病变患者,其中良性组37 例(包括黏膜息肉、内翻状乳头状瘤等),恶性组42 例(均为鳞状细胞癌).所有病例术前均行3.0T MRI 常规序列及 DCE-MRI 扫描,应用 Extended Tofts模型获取病灶容量转移常数(Ktrans)、速率常数及血管外细胞外间隙容积比(Ve)参数.采用 Man-Whitney U 检验比较组间差异,通过受试者工作特征曲线评估各参数的诊断效能.结果 恶性组 Ktrans[0.250(0.217,0.345)/min 比0.153(0.132,0.167)/min]及 Ve[0.644(0.402,0.880)比 0.294(0.211,0.437)]均显著高于良性组(P 均<0.001).受试者工作特征曲线分析证实Ktrans鉴别诊断效能最优(受试者工作特征曲线下面积=0.923,95%CI=0.167～0.225),最佳截断值0.187/min时敏感度为 88.1%,特异度为 89.2%;Ve 次之(受试者工作特征曲线下面积=0.796,95%CI=0.354～0.560),截断值0.355 时灵敏度为85.7%,特异度69.4%.结论 DCE-MRI 定量参数中,Ktrans 对头颈部良恶性病变具有优异的鉴别诊断价值,可作为可靠的独立预测因子,为术前无创评估提供重要影像学依据.
Objective To investigate the clinical value of quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in distinguishing between benign and malignant le-sions of the head and neck.Methods A retrospective cohort study was conducted.A total of 79 patients with pathologically confirmed space-occupying lesions of the head and neck were enrolled and were assigned into a be-nign group(n=37,including mucosal polyps and inverted papillomas)and a malignant group(n=42,all be-ing squamous cell carcinomas).All the patients underwent preoperative 3.0T MRI conventional sequences and DCE-MRI scans.The Extended Tofts model was adopted to obtain quantitative parameters:volume transfer con-stant(Ktrans),rate constant,and extravascular extracellular space volume fraction(Ve).The Mann-Whitney U test was performed to compare intergroup differences,and receiver operating characteristic curves were generated to evaluate the diagnostic performance of each parameter.Results The malignant group exhibited higher Ktrans[0.250(0.217,0.345)/min vs.0.153(0.132,0.167)/min]and Ve[0.644(0.402,0.880)vs.0.294(0.211,0.437)]than the benign group(both P<0.001).Receiver operating characteristic curves analysis demonstrated that Ktrans had the optimal diagnostic performance(area under the curve=0.923,95%CI=0.167-0.225),with the sensitivity of 88.1%and the specificity of 89.2%at a cut-off value of 0.187/min.Ve showed moderate performance(area under the curve=0.796,95%CI=0.354-0.560),achieving the sensitivity of 85.7%and the specificity of 69.4%at a cut-off value of 0.355.Conclusion Among the quantitative parameters of DCE-MRI,Ktrans demonstrates excellent value for differentiating between benign and malignant lesions of the head and neck,serving as a reliable independent predictor and providing critical imaging evidence for preoperative noninvasive evaluation.
鲍林;田亚忠;刘澍;刘梦琦;陈志晔
中国人民解放军总医院海南医院放射诊断科,海南 三亚 572013中国人民解放军总医院海南医院放射诊断科,海南 三亚 572013中国人民解放军总医院海南医院放射诊断科,海南 三亚 572013中国人民解放军总医院海南医院放射诊断科,海南 三亚 572013中国人民解放军总医院海南医院放射诊断科,海南 三亚 572013
医药卫生
动态对比增强MRI成像容量转移常数速率常数血管外细胞外间隙容积比
dynamic contrast-enhanced magnetic resonance imagingvolume transfer constantrate con-stantextravascular extracellular space volume fraction
《中国医学科学院学报》 2026 (2)
244-248,5
国家重点研发计划(2023YFF1203501)
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