Relationship between 1.5 T MR imaging features and the diagnosis of parotid tumor patients
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摘要:
目的探究并分析1.5 T MR影像特征与腮腺肿瘤病人良恶性诊断的关系及病理结果。 方法选取2016年5月~2019年5月收治的早期腮腺肿瘤患者70例，所有患者均在我院进行1.5 T MR检查，并经病理诊断确诊。其中良性肿瘤51例（良性肿瘤组），恶性肿瘤19例（恶性肿瘤组）。分析并比较良恶性肿瘤的MR及病理结果、良恶性肿瘤MR影像结果特点（包括位置、形态、密度、轮廓）、良恶性组MR时间信号曲线类型及峰值时间。 结果MR诊断腮腺肿瘤结果与病理学结果差异无统计学意义（P>0.05）；腮腺良恶性肿瘤MR影像学结果比较，差异有统计学意义（P < 0.05），良恶性肿瘤在位置、形态、密度、轮廓等表现差异均具有统计学意义（P < 0.05）；两组肿瘤MR动态特点比较，差异具有统计学意义（P < 0.05），良性组持续型、廓清型（廓清率≥0.3%）、平坦型比率高于恶性组（P < 0.05），恶性组廓清型（廓清率 < 0.3%）比率高于良性组（P < 0.05），良性组峰值时间高于对照组，差异具有统计学意义（P < 0.05）。 结论1.5 T MR在腮腺肿瘤病人良恶性诊断中具有较高的诊断效能，对于良恶性肿瘤的鉴别具有较大的价值，值得临床推广。 Abstract:ObjectiveTo explore and analyze the relationship between the 1.5T MR imaging features and the diagnosis of parotid tumor patients and the comparison of pathological results. Methods70 patients with early parotid tumor from May 2016 to May 2019 were selected. All patients were examined with 1.5T MR in our hospital and confirmed by pathological diagnosis. Among them, 51 cases were benign tumors (benign tumor group) and 19 cases were malignant tumors (malignant tumor group). The MR and pathological results of benign and malignant tumors, the characteristics of MR imaging results of benign and malignant tumors (including location, shape, density, contour), the types of MR time signal curve and peak time of benign and malignant groups were analyzed and compared. ResultsThere was no significant difference between MR diagnosis of parotid tumors and pathological results (P>0.05); there was significant difference between MR imaging results of parotid benign and malignant tumors (P < 0.05), and there was significant difference between the location, shape, density, contour and other manifestations of benign and malignant tumors (P < 0.05). There was significant difference between the two groups in the dynamic characteristics of tumor MR (P < 0.05), and between the benign group in the persistent type and the clearance type(clearance rate≥0.3%), flat type rate was significantly higher than malignant group (P < 0.05), malignant group clearance rate (clearance rate < 0.3%) was significantly higher than benign group (P < 0.05), benign group peak time was significantly higher than the control group (P < 0.05), with statistical significance. Conclusion1.5T MR has a high diagnostic efficiency in the diagnosis of parotid tumor patients, and it has a great value in the differentiation of benign and malignant tumors, which is worthy of clinical promotion. -
图 1 多形性腺瘤MR图像
A: 横断位增强示左侧腮腺深叶明显强化结节; B: 失状位增强示左侧腮腺区明显强化结节; C: 冠状位增强示左侧腮腺区明显强化结节.
Figure 1. MR imaging of pleomorphic adenoma.
图 2 多形性腺瘤病理图
Figure 2. Pathology of pleomorphic adenoma (HE, original magnification: ×20).
图 3 腮腺囊肿MR图像
A: 横轴位T2示右侧腮裂区结节状高信号，内部信号欠均匀; B: 冠状位T2示右侧腮裂区不均匀高信号结节; C: 冠状位增强示右侧腮裂区结节呈轻度边缘强化, 中心囊性区无明显强化.
Figure 3. MR imaging of parotid cyst.
图 4 Warthin瘤MR图像
A: 横轴位T2示左侧腮腺区结节状稍长T2信号; B: 冠状位T1示左侧腮腺区结节状稍长T1信号; C: 冠状位增强示左侧腮腺结节轻度环形强化, 内部囊性区强化不明显.
Figure 4. MR imaging of Warthin tumor.
表 1 MR及病理结果比较（n=70）
Table 1. Comparison of MR and pathological results
诊断方法 良性肿瘤 恶性肿瘤 MR 48 22 病理学 51 19 χ2 1.02 P > 0.05 
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表 2 良恶性肿瘤MR影像结果比较（n）
Table 2. Comparison of MR imaging results of benign and malignant tumors
病理 位置 形态 密度 轮廓 浅叶 深叶 圆形 分叶状 不均 伴囊性变 清晰 不清 良性肿瘤(n=51) 32 19 34 17 34 17 33 18 恶性肿瘤(n=19) 15 4 12 7 14 5 12 7 χ2 6.21 6.15 5.12 4.85 P 0.012 0.015 0.021 0.016
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表 3 良恶性组MR动态特点比较[n(%)]
Table 3. Comparison of MR dynamic characteristics between benign and malignant groups
组别 时间信号曲线类型 峰值时间（s, Mean±SD） 持续型 廓清型（廓清率≥0.3%） 廓清型（廓清率 < 0.3%） 平坦型 良性组（n=51） 167.20±24.12 腺淋巴瘤 9 (17.65) 6 (11.76) 0 2 (3.92) 多形性腺瘤 15 (29.41) 2 (3.92) 0 9 (17.65) 基底细胞瘤 3 (5.88) 0 0 3 (5.88) 血管瘤 1 (1.96) 0 0 1 (1.96) 总计 28 (54.90)* 8 (15.69)* 0 15 (29.41)* 恶性组（n=19） 75.12±23.15 黏液表皮样癌 1 (5.26) 0 5 (26.32) 0 淋巴瘤 1 (5.26) 0 4 (21.05) 0 腺样囊性癌 1 (5.26) 0 3 (15.79) 0 恶性混合瘤 0 0 2 (10.53) 0 腺泡细胞癌 0 0 1 (5.26) 0 其他 0 0 1 (5.26) 0 总计 3 (15.79) 0 16 (84.21)# 0 *P < 0.05 vs恶性组; #P < 0.05 vs良性组.
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[1] 蒋延伟, 孙程, 孙建, 等. 3D-iMSDE脉冲MR神经成像判断腮腺内面神经及腮腺导管与肿瘤解剖关系的价值[J]. 中华放射学杂志, 2019, 53(9): 755-60. doi: 10.3760/cma.j.issn.1005-1201.2019.09.008 [2] Yamamoto T, Kimura H, Hayashi K, et al. Pseudo-continuous arterial spin labeling MR images in Warthin tumors and pleomorphic adenomas of the parotid gland: qualitative and quantitative analyses and their correlation with histopathologic and DWI and dynamic contrast enhanced MRI findings[J]. Neuroradiology, 2018, 60(8): 803-12. doi: 10.1007/s00234-018-2046-9 [3] 宋承汝, 程敬亮, 张勇, 等. 高分辨率DWI表观扩散系数直方图鉴别腮腺常见肿瘤[J]. 放射学实践, 2019, 34(7): 749-54. https://www.cnki.com.cn/Article/CJFDTOTAL-FSXS201907008.htm [4] 冯旺. 常规MR联合DWI在腮腺常见肿瘤的诊断价值研究[J]. 养生保健指南, 2018(42): 295. https://www.cnki.com.cn/Article/CJFDTOTAL-FSXS201204008.htm [5] 潘桂海, 周飞, 陈武标, 等. 3.0T MRI动态增强对腮腺肿瘤良恶性的鉴别及其ADC值与病理分级的相关性研究[J]. 临床放射学杂志, 2019, 38(6): 1002-6. https://www.cnki.com.cn/Article/CJFDTOTAL-LCFS201906015.htm [6] Iida E, Wiggins RH, Anzai Y. Bilateral parotid oncocytoma with spontaneous intratumoral hemorrhage: a rare hypervascular parotid tumor withASL perfusion[J]. Clin Imaging, 2016, 40(3): 357-60. doi: 10.1016/j.clinimag.2016.02.003 [7] 习志兵. MRI联合DWI检查对腮腺肿瘤患者良、恶性鉴别诊断效能的影响[J]. 现代医用影像学, 2019, 28(1): 89-90, 94. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYY201901035.htm [8] 林明飞, 云昊, 陆裕富, 等. 3.0T磁共振动态增强成像与弥散加权成像对腮腺不同类型肿瘤的鉴别诊断[J]. 中华实验外科杂志, 2019, 36(4): 765-7. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYKX201202009.htm [9] Kato H, Fujimoto K, Matsuo M, et al. Usefulness of diffusionweighted MR imaging for differentiating between Warthin's tumor and oncocytoma of the parotid gland[J]. Jpn J Radiol, 2017, 35(2): 78-85. doi: 10.1007/s11604-016-0608-5 [10] 柴宇宁. 腮腺良恶性肿瘤的CT影像学表现及鉴别价值研究[J]. 影像研究与医学应用, 2018, 2(19): 33-4. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYY201819019.htm [11] 王海滨, 王理, 张乐星. 动态增强磁共振成像在腮腺肿瘤的诊断优势及研究进展[J]. 肿瘤学杂志, 2018, 24(6): 601-5. https://www.cnki.com.cn/Article/CJFDTOTAL-XHON201806015.htm [12] 宋承汝, 程敬亮, 张勇, 等. 基于分段读出扩散加权成像序列表观扩散系数图的全域直方图分析在腮腺常见肿瘤鉴别诊断中的价值[J]. 中华放射学杂志, 2019, 53(3): 189-95. http://d.wanfangdata.com.cn/periodical/zhfsx201903007 [13] Matsusue E, Fujihara Y, Matsuda E, et al. Differentiating parotid tumors by quantitative signal intensity evaluation on MR imaging [J]. Clin Imaging, 2017, 46: 37-43. doi: 10.1016/j.clinimag.2017.06.009 [14] Zhu L, Wang JB, Shi HM, et al. Multimodality fMRI with perfusion, diffusion-weighted MRI and 1 H-MRS in the diagnosis of lymphoassociated benign and malignant lesions of the parotid gland[J]. J Magn Reson Imaging, 2019, 49(2): 423-32. doi: 10.1002/jmri.26260 [15] 文萌萌, 张勇, 程敬亮, 等. 基于增强T1WI的直方图分析在腮腺常见肿瘤中的鉴别诊断价值[J]. 临床放射学杂志, 2020, 39(5): 895-9. https://www.cnki.com.cn/Article/CJFDTOTAL-LCFS202005015.htm [16] 王巍, 王超, 宋金丹. 腮腺多形性腺瘤与Warthin瘤的CT和MRI的影像学特征[J]. 临床和实验医学杂志, 2020, 19(6): 660-3. https://www.cnki.com.cn/Article/CJFDTOTAL-SYLC202006027.htm [17] Abdel Razek AAK, Samir S, Ashmalla GA. Characterization of parotid tumors with dynamic susceptibility contrast perfusionweighted magnetic resonance imaging and diffusion-weighted MR imaging[J]. J ComputAssist Tomogr, 2017, 41(1): 131-6. doi: 10.1097/RCT.0000000000000486 [18] Kandemirli SG. Unilateral submandibular gland aplasia mimicking nodal metastasis [J]. J Pediatr Hematol Oncol, 2020, 42(3): 220-1. doi: 10.1097/MPH.0000000000001634 [19] Sumikawa T, Yabuuchi H, Sumikawa C, et al. Influence of blade width and magnetic field strength on the ADC on PROPELLER DWI in head and neck[J]. Neuroradiol J, 2020, 33(1): 39-47. doi: 10.1177/1971400919870178 [20] Elmokadem AH, Abdel Khalek AM, Abdel Wahab RM, et al. Diagnostic accuracy of multiparametric magnetic resonance imaging for differentiation between parotid neoplasms[J]. Can Assoc Radiol J, 2019, 70(3): 264-72. doi: 10.1016/j.carj.2018.10.010 [21] Qian W, Xu XQ, Zhu LN, et al. Preliminary study of using diffusion kurtosis imaging for characterizing parotid gland tumors[J]. Acta Radiol, 2019, 60(7): 887-94. doi: 10.1177/0284185118803784 [22] van Dijk LV, Thor M, Steenbakkers RJHM, et al. Parotid gland fat related Magnetic Resonance image biomarkers improve prediction of late radiation-induced xerostomia[J]. Radiother Oncol, 2018, 128(3): 459-66. doi: 10.1016/j.radonc.2018.06.012 [23] Sequeira JP, Jagadishchandra, Mithun MS, et al. Ancient schwannoma of the parotid gland: a note on surgical management[J]. Ann Maxillofac Surg, 2019, 9(1): 221-2. doi: 10.4103/ams.ams_240_18 [24] Garrett SL, Trott K, Sebastiano C, et al. Sensitivity of fine-needle aspiration and imaging modalities in the diagnosis of low-grade mucoepidermoid carcinoma of the parotid gland[J]. Ann Otol Rhinol Laryngol, 2019, 128(8): 755-9. doi: 10.1177/0003489419842582 -
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