The Value Of IVIM-DWI And Quantitative DCE-MRI In The Differential Diagnosis Of Orbital Benign And Malignant Lesions

Objective:To investigate the value of Intravoxel incoherent motion-diffusion weighted imaging(IVIM-DWI)and quantitative contrast-enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis and differential diagnosis of orbital benign and malignant tumors.Methods:From November 2018 to December 2019,there were 50 patients with orbital diagnosis and surgical pathological confirmation of orbital benign and malignant tumors in the Fourth Affiliated Hospital of Kunming Medical University,of which 34 were benign and 16 were malignant.IVIM-DWI and quantitative DCE-MRI dynamic enhancement,surgery within two weeks after the completion of magnetic resonance.Post-processing IVIM and quantitative DCE-MRI images at GE Advantage Windows 4.6 and 4.7 post-processing workstations,manually selecting areas of interest,measuring D,D*,f values of IVIM and Ktrans,Kep,Ve,etc.Parameters,and measured dynamic enhancement time-signal curve(TIC),comparative analysis of benign group and malignant group related parameters.SPSS 22.0 software package was used for statistical analysis,chi-square test was performed on the gender of the two groups of patients,and independent sample T test was performed on the age.The relevant parameters of IVIM and quantitative DCE-MRI of the two groups were tested for normal distribution and homogeneity of variance,and independent sample T test was performed for the data that conformed to the normal distribution or the homogeneity of variance.Fisher's exact test was used to analyze the difference in TIC type composition ratio between the two groups.Taking the pathological results as the gold standard,the receiver operating characteristic curve(ROC)was used to analyze the IVIM-DWI,quantitative DCE-MRI parameters,and the sensitivity and specificity of the combined diagnosis of the two to evaluate their differential diagnosis ability.Finally,the correlation analysis between IVIM-DWI parameters D,D*,f values and quantitative DCE-MRI parameters Ktrans,Kep,Ve values was used Spearman correlation test of binary correlation analysis.P<0.05 was considered statistically significant.Results:1.IVIM-DWI:In 34 cases of benign group,DWI showed high and slightly high signal in 30 cases,equal signal in 2 cases,and low signal in 2 cases.In the malignant group,16 cases of DWI showed high signal;with the increase of b value,the signal of tumor gradually decreased.Comparing the IVIM-DWI parameters between the two groups,the difference in D and D*values was statistically significant(P<0.05),and the f value was not statistically different.The D*value of the malignant group was higher than that of the benign group,and the D value was lower than that of the benign group.The sensitivity of D and D*to the differential diagnosis of orbital tumor benign and malignant was 80.0%and 87.5%,and the specificity was 71.4%and 67.7%,respectively.The area under the curve(AUC)of the D value is the largest at 0.801.2.Quantitative DCE-MRI:30 cases of Ktrans and Ve pseudo color images in the benign group are red and yellow,and 4 cases are blue;Kep pseudo color images are 28 blue and 6 cases are red,yellow green,and blue mixed colors.In the malignant group,14 cases of Ktrans and Ve pseudo color images showed mixed colors of red,yellow green and blue,2 cases showed blue and green mixed colors,10 cases of Kep pseudo color images showed mixed colors of red,yellow green and blue,and 4 cases Mixed colors of blue and green.There was a statistically significant difference in quantitative DCE-MRI parameters Kep and Ve between the two groups(P<0.05),and there was no statistical difference in the Ktrans values between the two groups(P>0.05).Kep in the malignant group was higher than in the benign group,and Ve value was lower than in the benign group.Kep and Ve were 87.5%and 68.8%sensitive to orbital benign and malignant tumors,respectively,and 52.9%and 76.5%specificity.The area under the curve(AUC)of the Ve value is the largest at 0.726.3.TIC curve type:9 cases of type ? in benign group,21 cases of type ?,4 cases of type ?,0 cases of type ? in malignant group,11 cases of type ?,5 cases of type ?.Academic significance(P<0.05).4.Use ROC analysis to evaluate the diagnostic efficiency of quantitative DCE-MR1 combined with IVIM-DWI related parameters to distinguish benign and malignant orbital tumors.Ve value combined with D value AUC is 0.824,sensitivity is 75.0%,specificity is 88.2%;Ve value combined The AUC for D*value diagnosis was 0.789,sensitivity was 75.0%,and specificity was 76.5%;the AUC for Kep value combined with D value was 0.807,sensitivity was 98.3%,specificity was 58.8%;Kep value combined with D*value The diagnosed AUC was 0.783,the sensitivity was 87.5%,and the specificity was 73.5%;the combined diagnosis of the four was 0.847,the sensitivity was 81.3%,and the specificity was 76.5%.5.The D value in the IVIM-DWI parameter is positively correlated with the Ve value in the DCE-MRI parameter,and the correlation coefficient is 0.319.There was no significant correlation between the remaining parameters(P>0.05).Conclusions:1.IVIM-DWI parameters D and D*values and quantitative DCE-MRI parameters Kep and Ve values are helpful for the identification of benign and malignant orbital tumors,and can be used as a clinical imaging indicator to identify benign and malignant orbital tumors.2.IVIM-DWI combined with quantitative DCE-MRI can improve the diagnostic efficiency of benign and malignant differentiation of orbital tumors.