Improved Performance in Differentiating Benign from Malignant Sinonasal Tumors Using Diffusion-weighted Combined with Dynamic Contrast-enhanced Magnetic Resonance Imaging

作     者：Xin-Yan Wang Fei Yan Hui Hao Jian-Xing Wu Qing-Hua Chen Jun-Fang Xian Wang Xin-Yan;Yan Fei;Hao Hui;Wu Jian-Xing;Chen Qing-Hua;Xian Jun-Fang

作者机构：Department of Radiology Beijing Tongren Hospital Capital Medical University Beijing 100730 China Department of Radiology Beijing Tongren Hospital Capital Medical University Beijing 100730 China Beijing Key Laboratory of Nasal Diseases Beijing Institute of Otolaryngology Capital Medical University Beijing 100069 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2015年第128卷第5期

页      面：586-592页

核心收录：

学科分类：0810[工学-信息与通信工程] 0809[工学-电子科学与技术（可授工学、理学学位）] 07[理学] 070205[理学-凝聚态物理] 08[工学] 0805[工学-材料科学与工程（可授工学、理学学位）] 080502[工学-材料学] 081001[工学-通信与信息系统] 0702[理学-物理学] 

基　　金：This work was supported by Beijing Excellent Talents Foundation (No. 2010D003034000033) Beijing Municipal Natural Science Foundation (No. 7112030), and high levels of health technical personnel in Beijing city (No. 2011-3-047) 

主　　题：Diffusion-weighted Dynamic Contrast-enhanced Magnetic Resonance Imaging Nasal Cavity Neoplasm, Paranasal Sinus 

摘      要：Background：Differentiating benign from malignant sinonsal lesions is essential for treatment planning as well as determining the patient＇s prognosis,but the differentiation is often difficult in clinical *** study aimed to determine whether the combination of diffusion-weighted （DW） and dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） can improve the performance in differentiating benign from malignant sinonasal ***：This retrospective study included 197 consecutive patients with sinonasal tumors （116 malignant tumors and 81 benign tumors）.All patients underwent both DW and DCE-MRI in a 3-T magnetic resonance *** different settings ofb values （0,700 and 0,1000 s/mm^2） and two different strategies of region of interest （ROI） including whole slice （WS） and partial slice （PS） were used to calculate apparent diffusion coefficients （ADCs）.A DW parameter with WS ADCsb0.1000 and two DCE-MRI parameters （time intensity curve [TIC] and time to peak enhancement [Tpeak]） were finally combined to use in differentiating the benign from the malignant tumors in this ***：The mean ADCs of malignant sinonasal tumors （WS ADCsb0,1000=1.084 × 10^-3 mm^2/s） were significantly lower than those of benign tumors （WS ADCsb0,1000=1.617 × 10^-3 mm^2/s,P 〈 0.001）.The accuracy using WS ADCsb0,1000 alone was 83.7% in differentiating the benign from the malignant tumors （85.3% sensitivity,81.2% specificity,86.4% positive predictive value [PPV],and 79.5% negative predictive value [NPV]）.The accuracy using DCE with Tpeak and TIC alone was 72.1% （69.1% sensitivity,74.1% specificity,77.5% PPV,and 65.1% NPV）.Using DW-MRI parameter was superior than using DCE parameters in differentiation between benign and malignant sinonasal tumors （P 〈 0.001）.The accuracy was 87.3% （90.5% sensitivity,82.7% specificity,88.2% PPV,and 85.9% NPV） using DW-MRI combined with DCE-MRI,which was superior than that using DCE-MRI alone or using DW-MRI alone （both P 〈 0.001） in d