扩散加权成像单指数与双指数模型鉴别肺内良恶性实性肿块的对比研究

发布时间：2018-03-20 19:55

本文选题：肺肿瘤　切入点：磁共振成像　出处：《中国医学影像学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨扩散加权成像(DWI)单指数与双指数模型对肺内良恶性实性肿块的鉴别诊断价值。资料与方法纳入77例经病理证实的肺内肿块患者,共96个病灶,其中良性肿块48个,恶性肿块48个,包括19个鳞状细胞癌,29个腺癌。所有患者均行3.0T DWI,b值取0、50、100、150、200、400、600、800 s/mm~2。单指数及双指数模型测量肿块表观扩散系数(ADC)、慢速表观扩散系数(Dslow)、快速表观扩散系数(Dfast)及快速扩散比率(f)。结果良性肿块ADC值为(1.37±0.48)×10~(-3) mm~2/s、Dslow值为(1.34±0.45)×10~(-3) mm~2/s,显著高于腺癌[ADC(1.19±0.23)×10~(-3) mm~2/s,Dslow(1.12±0.35)×10~(-3) mm~2/s]及鳞状细胞癌[ADC(1.13±0.28)×10~(-3) mm~2/s,Dslow(1.02±0.32)×10~(-3) mm~2/s],腺癌与鳞状细胞癌之间差异无统计学意义(P0.05)。恶性肿块Dfast及f值高于良性肿块,但差异无统计学意义(P0.05)。ROC曲线显示Dslow判别良恶性肿块的准确度(72.2%)及敏感度(91.3%)高于其他参数(准确度55.5%~68.0%,敏感度41.3%~78.3%,P0.01)。结论 DWI双指数模型Dslow较ADC更准确地鉴别肺内良恶性病变。
[Abstract]:Objective to investigate the value of DWI single index and double index model in differential diagnosis of benign and malignant solid lung masses. 48 malignant masses, There were 19 squamous cell carcinomas and 29 adenocarcinoma. All patients were treated with 3.0T DWIIb value of 0.0T DWIIb. The apparent diffusion coefficient (ADCT), slow apparent diffusion coefficient (Dslowly) and fast apparent diffusion coefficient (Dfast) and rapid diffusion ratio (Dfast) and rapid diffusion ratio (Dfast) were measured by single index and double index models. Results the ADC value of benign mass was 1.37 卤0.48 脳 10 ~ (-8) 脳 10 ~ (-3) mm ~ (-3) mm ~ (-1) / s, which was 1.34 卤0.45 脳 10 ~ (-3) mm ~ (-2) / s, which was significantly higher than that of adenocarcinoma [ADC(1.19 卤0.23) 脳 10 ~ (-3) mm ~ (-3) mm~2/s. There was no significant difference between adenocarcinoma [ADC(1.19 卤0.23) 脳 10 ~ (-3) mm ~ (-3) mm~2/s] and squamous cell carcinoma (ADC(1.13 卤0.28) 脳 10 ~ (-3) mm ~ (-3) mm ~ (-2) S _ D _ D _ (1.02 卤0.32) 脳 10 ~ (-3) mm~2/s]. There was no significant difference between adenocarcinoma and squamous cell carcinoma (P _ (0.05)). The Dfast and f of malignant mass were higher than that of benign tumor. However, there was no significant difference in P0.05U .ROC curve between the two groups. The accuracy and sensitivity of Dslow in differentiating benign and malignant tumors were higher than those of other parameters (the accuracy was 55.5% and 68.0%, the sensitivity was 41.3% and 78.3% P0.01.Conclusion DWI double index model Dslow is more accurate than ADC in differentiating benign and malignant lung lesions.
【作者单位】：北京中医药大学第三附属医院放射科;南京医科大学第一附属医院放射科;国家食品药品监督管理总局医疗器械技术审评中心;
【分类号】：R445.2;R734.2

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