增强T1WI全域直方图鉴别脑原发淋巴瘤和脑单发转移瘤的价值
Whole-lesion histogram analysis of enhanced T1WI in identification of primary intracranial lymphoma and single intracranial metastases

目的:探讨增强T1WI全域直方图分析鉴别脑原发淋巴瘤和脑单发转移瘤的价值。方法:回顾性分析2014年11月至2017年11月经手术病理证实的58例颅内肿瘤患者资料,其中脑原发淋巴瘤30例、脑单发转移瘤28例。应用MaZda软件提取增强T1WI矢位图上肿瘤实质直方图特征,包括平均值,方差,偏度,峰度,第1、10、50、90、99百分位数等,分析两种肿瘤的差异。结果:增强T1WI全域直方图平均值,偏度,第1、10、50、90百分位数等特征在脑原发淋巴瘤和脑单发转移瘤间差异有统计学意义(P<0.05)。平均值,偏度,第1、10、50百分位数有较好的诊断效能(AUC>0.7),其中偏度诊断效能最佳,AUC为0.869,最佳临界值为-0.354,诊断的敏感度及特异度分别为85.7%和75.8%。结论:增强T1WI全域直方图分析可以为脑原发淋巴瘤和脑单发转移瘤的鉴别诊断提供更多量化信息特征,其中偏度诊断效能最佳。
Aim: To investigate the value of enhanced T1WI whole-lesion histogram analysis in differential diagnosis of primary brain lymphoma and single brain metastatic tumor.Methods: Retrospective analysis of 58 cases of intracranial tumors confirmed by surgery and pathology from November 2014 to November 2017, including 30 cases of primary brain lymphoma and 28 cases of single brain metastases. MaZda software was used to extract the features of tumor histograms on the T1WI map, including mean, variance, skewness, kurtosis, as well as 1st, 10th, 50th, 90th, 99th percentiles, and the differences between the two tumors were compared.Results: There were significant differences in the mean, skewness, 1st, 10th, 50th, and 90th percentile characteristics of the enhanced T1WI whole-lesion histogram between primary brain lymphoma and single brain metastasis(P<0.05).The mean, skewness, and 1st, 10th, and 50th percentiles had good diagnostic performance(AUC>0.7). Skewness had the best diagnostic performance and its AUC was 0.869, with the best cutoff value of -0.354,and sensitivity and specificity of 85.7% and 75.8%.Conclusion: Whole-lesion histogram analysis of enhanced T1WI could provide more quantitative information for the differential diagnosis of primary brain lymphomas and single brain metastases, and skewness has the best diagnostic performance