| 陈 洪,沈小程,曾 浩,胡 纳,付泉水,王 辉,杨国庆.MRI多b值DWI序列在孤立性肺结节良恶性鉴别诊断中的价值[J].,2018,(12):2373-2378 |
| MRI多b值DWI序列在孤立性肺结节良恶性鉴别诊断中的价值 |
| Value of MRI Multi-b values DWI Sequence in Differential Diagnosis of Benign and Malignant Solitary Pulmonary Nodule |
| 投稿时间：2017-09-02 修订日期：2017-09-28 |
| DOI：10.13241/j.cnki.pmb.2018.12.037 |
| 中文关键词: 孤立性肺结节 磁共振成像 扩散加权成像 |
| 英文关键词: Solitary pulmonary nodule Magnetic resonance imaging Diffusion weighted imaging |
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| 中文摘要: |
| 摘要 目的：评价MRI多b值DWI序列在孤立性肺结节（SPN）良、恶性鉴别诊断中的价值。方法：选取2015年9月-2016年6月于我院行CT检查发现并未经治疗的78例SPN患者，在穿刺活检或手术前行MRI 胸部检查，根据结节直径分为三组：D1≤10 mm、10 mm＜D2≤20 mm、20 mm＜D3≤30 mm，DWI扫描b值（0 s/mm2、400 s/mm2、600 s/mm2、800 s/mm2）。分别测量不同b值下结节DWI图的信号评分和拟合ADC图的表观扩散系数（ADCtot值），参照病理结果进行对比分析。结果：在b值为400 s/mm2时，良恶性结节DWI信号差异在D1组间无统计学意义（P>0.05）；当b值为600 s/mm2时，良恶性结节DWI信号差异在（D1、D2、D3）组间均具有统计学意义（P<0.05），且结节信号强度越高其恶性可能性越大；在b值为800 s/mm2时，良恶性结节DWI信号差异在D3组间无统计学意义（P>0.05）；在良恶性结节ADCtot值对比分析中发现，不同良性结节的ADCtot值均较恶性结节偏高，差异具有统计学意义（P<0.05）；以3为信号阈值，1.50×10-3 mm2/s为ADCtot阈值，对SPN的特异性、准确性、阳性预测值、阴性预测值均较信号强度评分升高（P<0.05）。结论：MRI弥散加权成像评价SPN过程中，多b值拟合ADCtot值对病变良恶性鉴别能力较好。在b值为600 s/mm2时，其信号强度差异对SPN的良恶性信号评价效能最佳，多b值DWI序列对SPN良恶性的鉴别诊断具有重要价值。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the value of MRI Multi-b values DWI sequence in differential diagnosis of benign and malig- nant solitary pulmonary nodule (SPN). Methods: 78 patients with SPN by CT examination and untreated from September 2015 to June 2016 in our hospita were selected, they were examined by MRI before the needle biopsy or surgery, and divided into three groups accord- ing to nodule diameter (D1≤10 mm, 10 mm2, 400s/mm2, 600 s/mm2, 800 s/mm2. The signal scores of DWI and the apparent diffusion coefficients (ADC) were measured under different b values (ADCtot value), the pathological findings were compared and analyzed. Results: When b=400 s/mm2, the differences of benign and malignant nodule DWI signal were not statistically significant among group D1 (P>0.05).When b=600 s/mm2, the differences of benign and malignant nod- ule DWI signal were statistically significant among group D1, group D2, group D3 (P<0.05), and the higher of the nodules signal intensity, the greater of the malignancy possibility. When b=800 s/mm2, the differences of benign and malignant nodule DWI signal were not statis- tically significant among group D3 (P>0.05). In the comparative analysis of benign and malignant nodules ADCtot values found that AD- Ctot values of different benign nodules were higher than those of malignant nodules, the differences were statistically significant (P<0.05). With 3 as the signal threshold and 1.50×10-3 mm2/s as the ADCtot threshold, the specificity, accuracy, positive predictive value and negative predictive value of SPN were higher (P<0.05). Conclusion: In the process of MRI diffusion weighted imaging evaluate SPN,Mulit-b values fitting ADCtot values is better for differential diagnosis of benign and malignant lesions. When b=600 s/mm2, the signal intensity difference of benign and malignant signals evaluation of SPN is the best. Mulit-b values DWI sequences have important value in differential diagnosis of benign and malignant of SPN. |
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