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Lymphoma and inflammation in the orbit: Diagnostic performance with diffusion‐weighted imaging and dynamic contrast‐enhanced MRI
Author(s) -
Sun Bo,
Song Liyuan,
Wang Xinyan,
Li Jing,
Xian Junfang,
Wang Feifei,
Tan Pan
Publication year - 2017
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25480
Subject(s) - medicine , magnetic resonance imaging , nuclear medicine , diffusion mri , receiver operating characteristic , lymphoma , effective diffusion coefficient , dynamic contrast , inflammation , radiology , pathology
Purpose To investigate the diagnostic performance of diffusion‐weighted imaging (DWI), dynamic contrast‐enhanced (DCE) magnetic resonance imaging (MRI), and the combination of both in the differential diagnosis of lymphoma and inflammation in the orbit. Materials and Methods This retrospective study was approved by the Institutional Review Board and the informed consent requirement was waived. A total of 53 patients underwent preoperative 3T MRI. Parameters of DWI and DCE MRI were evaluated in these 30 patients with orbital lymphoma and 23 patients with orbital inflammation. The diagnostic performance was evaluated using receiver operating characteristic curve analysis. Results Apparent diffusion coefficient (ADC) values and parameters derived from DCE MRI of orbital lymphoma and orbital inflammation differed significantly (ADC, T max , contrast index [CI], enhancement ratio [ER], and washout ratio [WR]: P < 0.001, P = 0.008, P < 0.001, P < 0.001, and P = 0.005 for reviewer 1, respectively; P < 0.001, P = 0.004, P < 0.001, P < 0.001, and P < 0.001 for reviewer 2, respectively). Sensitivity, specificity, and accuracy values of DWI were 76.67%, 100%, and 86.79% for reviewer 1; 70%, 95.65%, and 81.13% for reviewer 2, respectively. The combination of both were 90%, 86.96%, and 88.68% for reviewer 1; 93.33%, 78.26%, and 86.79% for reviewer 2, respectively. The combination of both was significantly superior to DWI for differentiation of orbital lymphoma from orbital inflammation ( P = 0.016 for reviewer 1; P = 0.001 for reviewer 2). Conclusion The combination of DWI and DCE MRI can improve diagnostic performance in differentiating lymphoma from inflammation in the orbit compared with DWI alone. Level of Evidence : 3 J. MAGN. RESON. IMAGING 2017;45:1438–1445