摘要
目的 探讨MR自旋回波扩散加权成像(turbo spin-echo diffusion-weighted imaging,TSE-DWI)在显示和鉴别胆脂瘤型中耳炎中的应用价值.方法 选取经手术证实的中耳炎患者 99 例,术前行常规MRI序列及TSE-DWI序列检查.根据手术及病理结果将患者分为胆脂瘤组 56 例及非胆脂瘤组 43 例.利用syngo.via后处理软件分别定量测量并计算胆脂瘤及非胆脂瘤病变的信号强度(signal intensity,SI)、信号强度比(signal intensity ratios,SIR)、ADC值.采用统计学方法检验两组中各参数的差异.采用受试者工作特征曲线(ROC)分析评估SI、SIR、和ADC值鉴别胆脂瘤和非胆脂瘤病变的最佳截断值.结果 胆脂瘤组的SI、SIR均值明显高于非胆脂瘤组,ADC均值明显低,差异有统计学意义(P<0.05).ROC曲线分析将SI、SIR、ADC值的截断值分别确定为 226.0、0.8、2.5×10-3mm2/s时,诊断胆脂瘤的灵敏度、特异度分别为 100%、97.7%;98.2%、97.7%;100%、97.7%.结论 TSE-DWI技术在鉴别诊断胆脂瘤与非胆脂瘤病变中具有很大优势,定量指标SI、SIR、ADC值可以帮助提高诊断的准确率.
Abstract
Objective To investigate the value of TSE-DWI sequence in the display and identification of cholesteatoma otitis media.Methods A total of 99 patients with otitis media confirmed by operation were examined by conventional MRI and TSE-DWI before operation.According to the surgical and pathological results,the patients were divided into cholesteatoma group and non-cholesteatoma group,with 56 cases and 43 cases in each group,respectively.The signal intensity(SI),signal intensity ra-tios(SIR)and ADCof cholesteatoma and non-cholesteatoma lesions were quantitatively measured and calculated using syngo.via post-processing software.Statistical methods were used to test the differences of parameters between the two groups.The receiver operating characteristic curve(ROC)was used to analyze the optimal cut off values of SI,SIR,and ADC in differentiating cho-lesteatoma from non-cholesteatoma lesions.Results The SI and SIR mean values in the cholesteatoma group were significantly higher,and the ADC mean values were significantly lower than the non-cholesteatoma group,with statistical significance(P<0.05).When the cutoff values of SI,SIR and ADC were determined to be 226.0,0.8 and 2.5×10-3mm2/s,the sensitivity and specificity of the diagnosis of cholestatoma were 100.0%and 97.7%;98.2%and 97.7%;100.0%and 97.7%,respectively.Con-clusion TSE-DWI imaging technology has great advantages in the differential diagnosis of cholesteatoma and non-cholesteatoma lesions,and the quantitative indexes SI,SIR and ADC values can help improve the diagnostic accuracy.
维普
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