多模态MRI对肺良恶性病变诊断的价值

发布时间：2018-06-23 10:06

本文选题：肺病变 + 扩散加权成像　；参考：《临床放射学杂志》2017年02期

【摘要】：目的研究多模态MRI在肺良恶性病变诊断中的价值。方法前瞻性搜集肺占位病变者81例,排除1例心脏搏动伪影及3例无法测出ADC值,最终纳入具有完整MRI图像病例77例。术前采用Philips 1.5 T MRI完成胸部常规序列、DWI和动态增强序列。所有病例分别测量b=600 s/mm~2和b=800 s/mm~2时病变区的ADC值,动态强化曲线根据Schaefer分型分为4种类型,比较不同序列联合应用诊断肺部恶性病变的敏感性、特异性及准确性,并采用配对卡方检验分析不同组的诊断效能。结果肺部良恶性病变的ADC值和DCE曲线有差异,恶性病变以A、B型曲线为主,b=600 s/mm~2时,良恶性病变平均ADC值分别为1.61×10~(-3)mm~2/s和1.27×10~(-3)mm~2/s;b=800 s/mm~2时,良恶性病变平均ADC值为1.46×10~(-3)mm~2/s和1.14×10~(-3)mm~2/s。且b=600 s/mm~2时诊断效能最高。常规MRI联合DCE及DWI诊断恶性病变的效能高于DCE组和DWI组,其敏感性、特异性和准确性分别为94.1%、88.5%和92.2%。结论 DCE联合DWI对良、恶性肺部病变的鉴别诊断有意义,可作为无典型形态学特征病变的重要补充。
[Abstract]:Objective to study the value of multimodal MRI in the diagnosis of pulmonary benign and malignant lesions. Methods 81 cases of pulmonary space occupying lesions were prospectively collected, 1 cases of cardiac pulsation artifacts were excluded and 3 cases were unable to detect ADC values. Finally, 77 cases with complete MRI images were included. The routine chest sequence, DWI and dynamic enhanced sequence were completed by Philips 1.5 T MRI before operation. The ADC values of the lesions in b=600 s/mm~2 and b=800 s/mm~2 were measured respectively. The dynamic strengthening curves were divided into 4 types according to the Schaefer classification. The sensitivity, specificity and accuracy of the combined application of different sequences in the diagnosis of pulmonary malignant lesions were compared, and the diagnostic efficacy of different groups was analyzed by paired chi square test. The ADC value of the benign and malignant pulmonary lesions was analyzed. DCE curve is different from that of DCE. The malignant lesions are mainly A and B curve. When b=600 s/mm~2, the average ADC values of benign and malignant lesions are 1.61 * 10~ (-3) mm~2/s and 1.27 x 10~ (-3) mm~2/s. The efficacy of diagnosis of malignant lesions is higher than that of group DCE and group DWI. Its sensitivity, specificity and accuracy are 94.1%, 88.5% and 92.2%. respectively. Conclusion DCE combined with DWI is significant for the differential diagnosis of benign and malignant pulmonary lesions, which can be used as an important supplement to the atypical morphological features.
【作者单位】：四川省德阳市人民医院放射科;四川省德阳市人民医院胸外科;
【基金】：四川省德阳市科技局科研项目(编号:2013SZ071-07)
【分类号】：R445.2;R734.2

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