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目的探讨动态增强磁共振成像(DCE-MRI)定量分析对眼眶良恶性肿块的鉴别诊断价值。方法回顾性分析经手术病理或临床随访证实的眼眶肿块64例,其中良性35例、恶性29例。DCE-MRI数据采用改良Tofts双室模型进行处理,获得定量参数:容量转运常数(K~(trans))、返流速率常数(K_(ep))和血管外细胞外间隙容积分数(V_e)。采用独立样本t检验比较良恶性组定量参数的差异,并利用受试者工作特性(ROC)曲线法分析各参数诊断眼眶恶性肿块的效能。结果眼眶恶性组K_(ep)值高于良性组(P=0.015),V_e值低于良性组(P=0.007),两组间K~(trans)值差异无统计学意义(P=0.700)。ROC曲线分析提示以V_e≤0.233诊断眼眶恶性肿块,可以获得最优的诊断效能(AUC 0.741;敏感度65.5%;特异度80.0%)。结论 DCE-MRI定量分析对眼眶良恶性肿块的鉴别诊断有一定价值,可为肿块定性诊断提供依据。
Objective To investigate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the differential diagnosis of orbital benign and malignant tumors. Methods A retrospective analysis of 64 cases of orbital masses confirmed by surgical pathology or clinical follow-up was performed, of which 35 were benign and 29 were malignant. The DCE-MRI data were processed with a modified Tofts two-compartment model to obtain quantitative parameters: K (trans), reflux rate constant (K ep) and extravascular extracellular volume fraction (V_e). Independent sample t-test was used to compare the differences of quantitative parameters between benign and malignant groups, and the performance of orbital malignant tumors was analyzed by ROC curves. Results The K ep values in orbital malignant group were significantly higher than those in benign group (P = 0.015) and V_e was lower than that in benign group (P = 0.007). There was no significant difference in K trans between the two groups (P = 0.700) . The ROC curve analysis suggested that the best diagnostic efficacy (AUC 0.741; sensitivity 65.5%; specificity 80.0%) was obtained when V_e≤0.233 was used to diagnose orbital malignant tumors. Conclusion DCE-MRI quantitative analysis of benign or malignant orifices have some value in the differential diagnosis, which can provide a basis for qualitative diagnosis of lumps.