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目的探讨扩散加权成像(DWI)和表观扩散系数(ADC)值在诊断及鉴别诊断眼眶良恶性病变中的价值。方法对78例眼眶病变患者于治疗前行常规MRI平扫和DWI检查,其中眼眶良性病变45例,恶性病变33例,测量病变的ADC均值,进行校正t检验统计处理和分析,运用受试者工作特征曲线(ROC)评价ADC值的诊断价值。结果良性病变ADC值为(1.42±0.36)×10~(-3)mm~2/s,恶性病变ADC值为(0.70±0.19)×10~(-3)mm~2/s,恶性病变ADC值明显低于良性病变(t值为-11.43,P=0.000)。ADC值诊断眼眶良恶性病变的ROC曲线下面积为0.978,ADC值以1.03×10~(-3)mm~2/s为阈值时,以病理结果为对照,判断眼眶病变良恶性的敏感度为93.3%,特异度为100%,准确率为96.2%,与病理结果行一致性检验,Kappa值为0.922。结论眼眶良恶性病变具有不同的扩散特征,ADC值对于两者之间的鉴别诊断具有重要参考价值,可提高诊断正确率。
Objective To investigate the value of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) in the diagnosis and differential diagnosis of benign and malignant orbital lesions. Methods 78 patients with orbital lesions were examined by conventional MRI and DWI before treatment. Among them, 45 were benign orbital lesions and 33 were malignant lesions. Mean ADC values were measured and corrected by t-test. The working characteristic curve (ROC) was used to evaluate the diagnostic value of ADC value. Results The ADC value of benign lesions was (1.42 ± 0.36) × 10 ~ (-3) mm ~ 2 / s and the malignant lesions were (0.70 ± 0.19) × 10 ~ (-3) mm ~ 2 / Values were significantly lower than in benign lesions (t -11.43, P = 0.000). The area under the ROC curve of ADC value for diagnosing benign and malignant orbital lesions was 0.978. When the ADC value was 1.03 × 10 -3 mm 2 / s, the pathological results were used as the control to determine the sensitivity of orbital disease to benign and malignant lesions as 93.3%, specificity was 100%, accuracy rate was 96.2%, consistent with the pathological results line test, Kappa value of 0.922. Conclusion The orbital benign and malignant lesions have different diffusion characteristics. The ADC value has important reference value for the differential diagnosis between the two, which can improve the diagnostic accuracy.