扩散加权成像在鉴别周围型肺癌及感染性肉芽肿中的应用

发布时间：2018-06-04 14:19

本文选题：磁共振成像 + 扩散加权成像　；参考：《广东医学》2015年04期

【摘要】：目的探讨磁共振扩散加权成像(DWI)在鉴别周围型肺癌及感染性肉芽肿的价值及最佳b值。方法收集胸部CT发现肺部孤立性病变的患者38例,周围型肺癌30例,感染性肉芽肿8例,均经过临床病理资料证实。所有患者术前或治疗前均进行DWI,b值为0、600、800、1 000 s/mm2,测量不同b值的平均表观扩散系数(ADC)值并比较。结果当b值为600、800、1 000 s/mm2,周围型肺癌的平均ADC值均明显小于感染性肉芽肿,差异均有统计学意义(P0.05)。周围型肺癌、感染性肉芽肿ADC值均随b值增加逐渐变小,且差异均有统计学意义(F=10.857,P0.001)。b值取600、800、1 000 s/mm2时,曲线下面积分别为0.917、0.804、0.783;其中b值为600 s/mm2时诊断效能最高,鉴别良恶性病变的最佳阈值为1.35×10-3mm2/s,敏感度和特异度分别为96.7%和75.0%。结论平均ADC值可作为鉴别周围型肺癌与感染性肉芽肿的有效补充手段,当b值为600 s/mm2时诊断效能最高。
[Abstract]:Objective to evaluate the value and the best b value of diffusion-weighted magnetic resonance imaging (DWI) in differentiating peripheral lung cancer from infectious granuloma. Methods 38 cases of pulmonary solitary lesions, 30 cases of peripheral lung cancer and 8 cases of infectious granuloma were collected and confirmed by clinical and pathological data. All patients were treated with DWIb of 0 600 800 s-1 000 s / m 2 before operation or before treatment. The mean apparent diffusion coefficient (ADCC) of different b values was measured and compared. Results when b value was 600 800 ~ 1 000 s / mm ~ (2), the average ADC value of peripheral lung cancer was significantly lower than that of infectious granuloma, and the difference was statistically significant (P 0.05). The ADC values of peripheral lung cancer and infectious granuloma gradually decreased with the increase of b value, and the difference was statistically significant when the value of F _ (10. 857) P _ (0.001) 路b was 600 800 ~ 1 000 s/mm2, the area under the curve was 0.917 ~ 0.804 ~ 0.78 _ 3 respectively, and the diagnostic efficacy was highest when b value was 600 s/mm2. The best threshold for differentiating benign and malignant lesions was 1.35 脳 10 ~ (-3) mm ~ (-2) / s, and the sensitivity and specificity were 96.7% and 75.0%, respectively. Conclusion the mean ADC value can be used as an effective supplementary method for differentiating peripheral lung cancer from infectious granuloma. When b value is 600 s/mm2, the diagnostic efficiency is the highest.
【作者单位】：广州医科大学附属第一医院放射科;
【分类号】：R445.2;R734.2

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