Dynamic Contrast‐Enhanced MRI Parameters and Normalized ADC Values Could Aid Differentiation of Skull Base Osteomyelitis from Nasopharyngeal Cancer

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FIG 1.
A case of SBO in a 68-year-old man. Postcontrast fat-suppressed T1-weighted image (A) shows ill-defined enhancement in the nasopharynx, prevertebral space, left parapharyngeal space, and left masticator space (arrows). The ADC map (B) shows 3 ROIs (Nos. 1 − 3, small circles) within high-signal lesion and 1 ROI (No. 4, small circle) for reference in the spinal cord, with an nADC_mean of 1.86. DCE-MR imaging (C, Kep map; D, Ve map) shows the lesion (thick arrows) with a Kep of 0.42 minute⁻¹ and Ve of 0.54.
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FIG 2.
A case of nasopharyngeal cancer in a 37-year-old man. A mass lesion with enhancement (arrows) mainly on the right side of the nasopharynx is observed on the postcontrast fat-suppressed T1-weighted image (A). An ADC map (B) shows 3 ROIs (Nos. 1 − 3, small circles) within a low-signal lesion and 1 ROI (No. 4, small circle) for reference in the spinal cord, with an nADC_mean of 0.86. DCE-MR imaging (C, Kep map; D, Ve map) shows the lesion (thick arrows) with a Kep of 3.14 minute⁻¹ and a Ve of 0.36.
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FIG 3.
The decision tree model incorporating DCE parameters (Kep and Ve) and the nADC_mean.

Table 1:

Demographic and clinical information of nasopharyngeal cancer

Table 2:

DCE-MR imaging and ADC parameters^{^a}

DCE Parameters	SBO	Nasopharyngeal Cancer	P Value
Ve	0.48 (0.36–0.55)	0.38 (0.14–0.63)	.15
Vp	0.14 (0.04–2.36)	0.12 (0.05–0.26)	.99
K^trans (min⁻¹)	0.20 (0.15–0.39)	0.28 (0.06–1.42)	.51
Kep (min⁻¹)	0.43 (0.31–0.48)	0.57 (0.31–3.70)	.04^{^b}
ADC value	1.48 (1.14–1.84)	0.69 (0.55–1.39)	<.001^{^b}
Reference ADC	0.79 (0.54–0.94)	0.81 (0.73–0.90)	.39
nADC_mean	1.90 (0.61–2.48)	0.87 (0.61–1.90)	<.001^{^b}