Preliminary Study On Differential Diagnosis Of Benign And Malignant Neoplasms In The Nasal Or Sinonasal Cavity By 3D-ASL And DWI

Objective:To investigate the value of magnetic resonance arterial spin labeling（ASL）and diffusion-weighted imaging（DWI）in the differential diagnosis of benign and malignant neoplasms of nasal or sinonasal cavity.Methods:This study was a prospective study of patients with clinically suspected nasal and sinus neoplasms in our hospital from June 2017 to June 2018 who were confirmed by surgery and pathology.All performed by 3.0T magnetic resonance ASL and DWI.The images were processed by Functool 4.4 software,The lesions were measured by drawing ROI to get the mTBF（mean tumor blood flow）value and mean ADC value and the Mann-Whitney U test and the independent sample t-test were used to compare the two groups of parameters of benign and malignant neoplasms.For the different parameters,the receiver operating characteristic curve（ROC）was used to analyze the optimal diagnostic threshold,and the sensitivity and specificity were calculated.Results:35 patients were actually scanned,but 25 patients were included in the study because 10 did not meet the inclusion criteria.There are 18 males,7 females,mean age53.8 years,11 benign masses,14 malignant tumors.The mTBF value of benign group was 35.1±20.4ml·min^-1·100 g^-1,and the mTBF value of malignant group was133.3±95.7ml·min^-1·100 g^-1.The difference between the two groups was statistically significant（P<0.05）.When the diagnostic threshold of mTBF in the benign and malignant group was determined to be 48.0 ml·min^-1·100 g^-1,the diagnostic sensitivity was 92.9%and the specificity was 90.9%.ADC value of benign group neoplasms were（1.67±0.34）×10^-3mm²/s,and ADC value of malignant group:（0.86±0.27）×10^-3mm²/s,the difference was statistically significant（P<0.05）.When the cutoff point value of the ADC value of the benign and malignant group was selected to be 1.11x10^-33 mm²/s,the diagnostic sensitivity was 100%and the specificity was 85.7%.Conclusion:The mTBF value of 3D-ASL and the ADC value of DWI have important differential diagnostic value for benign and malignant neoplasms of nasal or sinonasal cavity.