常规SE序列和高分辨MRI动态增强诊断胸膜局灶性病变的比较  

Topical focus in pleura: comparison of conventional SE sequence and breath-hold dynamic contrast-enhanced HR-MR images

作　　者：叶伟[1] 邓东[1] 龙莉玲[1] 黄仲奎[1] 梁秀咸[1] 黄践[1] 梁登成[1] 陆力坚[1] 

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《中国医学影像技术》2006年第2期299-302,共4页Chinese Journal of Medical Imaging Technology

基　　金：广西科学基金资助项目(0342036)。

摘　　要：目的比较常规SE序列与高分辨MR(HR-MR)动态增强扫描显示胸膜局灶性病变的价值。方法对30例胸膜局灶性病变做了常规SE平扫和HR-MR T1WI动态增强扫描;进行了图像对比噪声比(CNR)值的测量,分析比较常规SE序列和动态增强的图像质量、病灶检出情况和病灶与周围胸壁深层结构的显示情况。结果30例胸膜局灶性病变总的CNR值在动态增强早期、增强后期和延迟期均高于T2WI(P均<0.05或<0.01),但具体到不同病种,则不同扫描序列CNR值各不相同。含胶原纤维成分的良性肿瘤T2WI的CNR值均高于动态增强(P均<0.01);胸膜恶性肿瘤动态增强的CNR值则均高于T2WI(P<0.05或<0.01);炎性病变动态增强的CNR值亦高于T2WI(P<0.05或<0.01)。MR动态增强的清晰度、图像质量等评分均高于T2WI(P均<0.01);而T2WI的伪影最多,多于动态增强(P<0.01)。HR-MRI T1WI动态增强扫描可检出所有胸膜局灶性病灶且有助于明确病灶的内部结构及其血流灌注情况,且在显示肿瘤浸润胸壁的深层结构的准确性较常规SE序列要高。结论动态增强HR-MRI扫描可提高胸膜恶性病变和炎症病变的对比噪声比值,能改善图像质量,有助于明确病灶的浸润范围,对胸膜局灶性病变有一定的诊断价值。Objective To compare the non-enhanced conventional SE images with breath-hold dynamic contrast-enhanced HR-MR images in the diagnosis of topical focus in pleura. Methods Routine SE and breath-hold dynamic contrast-enhanced HR-MR TlWI images were performed on 30 patients with topical focus in pleura. Quality and quantity analysis were conducted based on contrast to noise ratio （CNR） and image quality of various sequences. Results Total CNRs in early, late and delayed stages of dynamic enhancement in the 30 patients were significantly higher than those of T2WI （P〈0.05 or 0.01）. But in different entity, the CNR varied with particular sequence. CNR of T2WI for benign tumor was higher than that of dynamic enhancement （P〈0.01）, and the CNR of dynamic contrast scanning in patients with malignant tumor was the highest （P〈0.05 or 0.01）. CNR of dynamic contrast scanning in cases with inflammation was also much higher than that of T2WI （P〈0.05 or 0.01）. Both image definition and quality of dynamic contrast scanning were higher than that of T2WI （P〈0.01）. More false shadows were observed with T2WI than with dynamic contrast scanning （P〈0.01）. Dynamic contrast-enhanced HR-MR images could detect all topical focus in pleura, and was helpful in defining the internal structure, infiltration extent and vascularity of topical focus in pleura. Conclusion CNR and image quality can be improved by dynamic HR-MR contrast scanning for diagnosis of topical malignant tumor and inflammation in pleura. The ability to detect the pleural lesion infiltration on chest wall better make it a useful method in the diagnosis of local pleural disease.

关 键 词：胸膜疾病 图像增强 磁共振成像 

分 类 号：R561[医药卫生—呼吸系统] R445.1[医药卫生—内科学]