#br# 体素内不相干运动扩散加权成像鉴别早期#br# 鼻咽癌与鼻咽良性增生的价值#br#

目的探讨体素内不相干运动扩散加权成像(IVIM DWI)在早期鼻咽癌(NPC)与鼻咽部良性增生鉴别中的价值。方法选取2018年5月至2019年5月在中山市中医院行MRI检查并进行IVIM DWI成像的早期NPC患者(n=46)和鼻咽部良性增生患者(n=43)作为研究对象,所有患者均经病理组织学检查证实,记录所有患者的真实扩散系数(D)、灌注分数(f)、灌注相关扩散系数(D*)、表观扩散系数(ADC),比较两组各参数之间的差异;绘制ROC曲线并计算曲线下面积(AUC),评估各参数诊断性能。结果与鼻咽良性增生组相比,早期NPC组的D、ADC0～1 000、ADC300～1 000较低(067±005)×10-3 mm2/s vs. (090±011)×10-3 mm2/s、(065±009)×10-3 mm2/s vs. (100±015)×10-3 mm2/s、 (059±005)×10-3 mm2/s vs. (076±010)×10-3 mm2/s](P<0001),而早期NPC组的D*则高于鼻咽良性增生组(3287±480)×10-3 mm2/s vs. (2187±521)×10-3 mm2/s](P<0001);两组之间f的差异无统计学意义(P=0216)。D和ADC300～1 000的AUC分别为0985和0988,D<075×10-3 mm2／s鉴别早期NPC与鼻咽良性增生的灵敏度、特异度和准确度最高(100％、975％和969％)。结论IVMI DWI在鉴别早期NPC和鼻咽良性增生中具有一定的价值,其中D和ADC300～1 000鉴别诊断性能最佳。

Value of intravoxel incoherent motion diffusion-weighted MRI for distinguishing early nasopharyngeal carcinoma from benign hyperplasia

Objective To investigate the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)MRI in distinguishing nasopharyngeal carcinoma(NPC)from benign hyperplasia in early stage.Methods Forty-six patients with early-stage NPC and 43 patients with benign hyperplasia receiving IVIM-DWI whose lesions were confirmed by pathology were selected.The mean pure diffusion coefficient(D),pseudo-diffusion coefficient(D*),perfusion fraction(f)and apparent diffusion coefficient(ADC)values of two groups were recorded and compared.Receiver operating characteristics(ROC)with the area under the curve(AUC)was used to evaluatethe diagnostic efficiency.Results Compared with benign hyperplasia,early-stage NPC exhibited a significantly lower D mean(0.67±0.05]×10^-3mm²/s vs.0.90±0.11]×10^-3mm²/s),ADC0-1000(0.65±0.09]×10^-3mm²/s vs.1.00±0.15]×10^-3mm²/s),ADC300-1000(0.59±0.05]×10^-3mm²/s vs.0.76±0.10]×10^-3mm²/s)and a higher D*mean(32.87±4.80]×10^-3mm²/s vs.21.87±5.21]×10^-3mm²/s)(all P<0.001).There was no significant difference in the f value between the two groups(P=0.216).The cutoff value of D was 0.75×10^-3mm²/s,with the sensitivity of 100%,specificity of 97.5%and accuracy of 96.9%.The AUC of ADC300-1000 was 0.988.Conclusions IVIM-DWI has potential to distinguish early-stage NPC from benign hyperplasia.D and ADC300-1000 mean are the appropriateparameters.