动态增强MRI在肺部结块病变中的诊断价值

发布时间：2018-05-23 17:17

本文选题：肺结节 + 肺肿瘤　；参考：《放射学实践》2017年04期

【摘要】：目的:探讨动态增强MRI在肺部结块样病变中的诊断价值。方法:66例经病理证实的肺结块样病变患者(恶性病变50例,良性病变16例)行常规MRI平扫及动态增强(DCE-MRI)检查,绘制时间-信号强度增强比曲线(TIC),并测量DCE-MRI参数:最大增强比(MER)、达峰时间(T_(max))、平均强化斜率(SLE)、最大强化斜率(SS)和廓清率。结果:本组病变的TIC分为4种类型:速升-下降型(A型)仅见于恶性肿瘤;速升-平台型和持续缓升型在良恶性结节中均可见,无明显强化型仅见于良性病变。肺鳞癌和小细胞癌的主要强化方式为环状强化,而腺癌为不均匀强化。DCE-MRI参数中,良性组Tmax明显较恶性组长(P0.001),SLE明显小于恶性组(P=0.002)。T_(max)对良恶性病变的鉴别最具价值,临界值取280s时其诊断敏感度、特异度和符合率分别为88.0%、63.5%和76.5%。结论:DCE-MRI能提供肺结节血流动力学方面的信息,对肺部良恶性肿瘤的鉴别诊断具有较高价值。
[Abstract]:Objective: to evaluate the diagnostic value of dynamic contrast enhanced MRI in pulmonary caking lesions. Methods Sixty-six patients with pathologically proved pulmonary caking lesions (50 malignant lesions and 16 benign lesions) were examined by routine MRI plain scan and dynamic contrast enhanced Mr imaging (DCE-MRI). The time-signal intensity enhancement ratio curve was plotted and the DCE-MRI parameters were measured as follows: maximum enhancement ratio (MERA), peak time (T), mean enhancement slope (SLEA), maximum enhancement slope (SSS) and clearance rate. Results: there were four types of TIC in this group: type A of rapid ascending and descending type) was only found in malignant tumor, the type of rapid rise and platform and the type of sustained slow rise were all visible in benign and malignant nodules, but no enhancement type was found only in benign lesions. The main enhancement mode of lung squamous cell carcinoma and small cell carcinoma was annular enhancement. In the non-homogeneous enhancement. DCE-MRI parameter of adenocarcinoma, benign group Tmax was significantly lower than malignant group P0.002%. Tstack max. was the most valuable in differentiating benign and malignant lesions. The main enhancement pattern of lung squamous cell carcinoma and small cell carcinoma was annular enhancement, while that of adenocarcinoma was inhomogeneous enhancement .DCE-MRI parameters showed that benign group was significantly lower than malignant group (P 0.001). When the critical value was 280s, the diagnostic sensitivity, specificity and coincidence rate were 88.0 and 76.5s, respectively. Conclusion: DCE-MRI can provide hemodynamic information of pulmonary nodules and is of great value in differential diagnosis of benign and malignant lung tumors.
【作者单位】：华中科技大学同济医学院附属同济医院放射科;海南省第三人民医院;
【分类号】：R445.2;R734.2

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