Differential diagnosis of benign and malignant tumors of temporal bone by conventional MRI combined with readout segmentation of long variable echo-trains diffusion weighted imaging
Wang Peng, Xiao Zebin, Tang Zuohua, Hong Rujian
Department of Radiology, Eye and ENT Hospital of Fudan University, Shanghai 200031, China
Abstract:Objective To evaluate the value of conventional MRI combined with readout segmentation of long variable echo-trains diffusion weighted imaging (RESOLVE-DWI) to differentiate the benign from the malignant tumors of the temporal bone. Methods The clinical and imaging data of 96 patients with temporal bone tumors, as confirmed by histopathology, were retrospectively analyzed in Eye and ENT Hospital of Fudan University from January 2014 to December 2019. Conventional MRI and RESOLVE-DWI were performed on all patients within 2 weeks before surgery. The following features were assessed with conventional MRI: tumor size (maximum diameters on the maximum transverse plane), shape, signal uniformity, boundary, and enhancement degree. Using post-processing software, apparent diffusion coefficient (ADC) values were obtained by drawing freehand circular regions of interest on the solid area of the tumor. The conventional MRI features and ADC values of benign and malignant tumors were compared by using the chi-square test and t-test. The receiver operating characteristic curve (ROC) of conventional MRI and ADC values alone or in combination was obtained to differentiate the benign from the malignant tumors of the temporal bone. The Delong test was used to compare the diagnostic efficiency. Results Fifty-nine patients, including 28 males and 31 females, had benign tumor of the temporal bone. They had an average age of 44.63±12.97 years old. Conventional MRI results showed that the benign tumors were 2.39±0.89 cm in size; some of these benign tumors were oval/slightly lobulated in shape (n=41), whereas others had an irregular shape (n=18), a well-defined boundary (n=52), an ill-defined boundary (n=7), a homogeneous signal (n=37), a heterogeneous signal (n=22), mild/moderate enhancement (n=34), and obvious enhancement (n=25). Thirty-seven patients, including 18 males and 19 females, had malignant tumor of the temporal bone. Their average age was 50.27±17.25 years old. Conventional MRI results showed that the malignant tumors were 2.58±1.16 cm in size; some of these malignant tumors were oval/slightly lobulated in shape (n=23), whereas others had an irregular shape (n=14), a well-defined boundary (n=17), an ill-defined boundary (n=20), a homogeneous signal (n=27), a heterogeneous signal (n=10), mild/moderate enhancement (n=9), and obvious enhancement (n=28). The tumor boundary and enhancement degree were statistically significant (all P values<0.01) and could be used to distinguish the benign from the malignant tumors of the temporal bone. No significant differences was found for age, gender, or other features scanned by conventional MRI (all P values> 0.05). The ADC value of malignant tumor was (0.91±0.23)×10-3 mm2/s, which was lower than that of benign tumor (1.09±0.32)×10-3 mm2/s, and the difference was statistically significant (t=2.974, P<0.01). The area under ROC curve (AUC) of conventional MRI in the differential diagnosis of the benign and malignant tumors of the temporal bone was 0.771 (95% CI 0.639-0.903) with sensitivity, specificity, and accuracy values of 68.42%, 85.71%, and 75.08%, respectively. The AUC of the ADC value was 0.727 (95% CI 0.565-0.889) with sensitivity, specificity, and accuracy values of 63.16%, 71.43%, and 66.35%, respectively. The AUC of the combination of conventional MRI and RESOLVE-DWI was 0.907 (95% CI 0.816-0.998) with sensitivity, specificity, and accuracy values of 89.47%, 80.95%, and 86.19%, respectively. The AUC value of the combination of conventional MRI with RESOLVE-DWI was significantly higher than the individual AUC values of these methods when used on their own (Z=2.463, 2.243, all P values<0.05). Conclusions Conventional MRI and RESOLVE-DWI are of great value in the differential diagnosis of the benign and malignant tumors of the temporal bone. Their combination can further improve the diagnostic efficiency.
王鹏, 肖泽彬, 唐作华, 洪汝建. 常规MRI联合分段读出平面回波弥散加权成像在颞骨良恶性肿瘤鉴别诊断中的应用价值[J]. 中华解剖与临床杂志, 2020, 25(6): 606-611.
Wang Peng, Xiao Zebin, Tang Zuohua, Hong Rujian. Differential diagnosis of benign and malignant tumors of temporal bone by conventional MRI combined with readout segmentation of long variable echo-trains diffusion weighted imaging. Chinese Journal of Anatomy and Clinics, 2020, 25(6): 606-611.
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