扩散加权成像鉴别肺恶性肿瘤与实性良性病变的初步研究  

A Preliminary Study on Distinguishing Pulmonary Malignant Tumors from Solid Benign Lesions by Diffusion-weighted Imaging

作　　者：刘海东[1,2] 于铁链[1] 刘颖[1] 叶宁[1] 

机构地区：[1]天津医科大学总医院放射科,300052 [2]天津市中心妇产科医院,300052

出　　处：《临床放射学杂志》2010年第2期179-182,共4页Journal of Clinical Radiology

摘　　要：目的探讨扩散加权成像(diffusion-weighted imaging,DWI)对肺恶性肿瘤与实性良性病变的鉴别诊断价值。资料与方法62例肺内恶性肿瘤和实性良性病变(共66个病灶)行常规MRI和DWI检查,b值为500s/mm2,观察病变区DWI信号特点并测量其表观扩散系数(apparent diffusion coefficient,ADC)值。结果不同病变组DWI信号虽有一定特点,但不具特征性。恶性病变组和良性病变组ADC值分别为(1.256±0.320)×10-3mm2/s、(1.648±0.416)×10-3mm2/s,两者差异有统计学意义(t=-3.637,P=0.001),ADC值鉴别肺内良恶性病变的最佳诊断阈值为1.400×10-3mm2/s,敏感性和特异性分别为83.3%和74.1%;小细胞肺癌ADC值为(1.064±0.196)×10-3mm2/s,非小细胞肺癌ADC值为(1.321±0.335)×10-3mm2/s,两者差异亦有统计学意义(t=2.967,P=0.007);原发性肺癌ADC值为(1.255±0.328)×10-3mm2/s,肺转移瘤ADC值为(1.263±0.280)×10-3mm2/s,两者差异无统计学意义(t=0.063,P>0.05)。结论ADC值有助于肺内良、恶性病变的鉴别诊断,有望成为一种具有临床实用价值的鉴别诊断方法。Objective To investigate the role of diffusion-weighted imaging （DWI） in the differential diagnosis between pulmonary malignant tumors and solid benign lesions. Materials and Methods Sixty-two patients with sixty-six lesions were enrolled in this study. Conventional MRI and DWI （diffusion factor of 0 and 500 s/mm^2） examinations were performed at 1.5T MR scanner. Signal intensity of DWI images were observed and ADC values of the lesions were measured. Results The signal intensity of pulmonary malignant tumors and solid benign lesions appeared no characteristic,but the ADC value of benign lesions was statistically higher than that of malignant tumors （ t=-3.637,P =0.001）,the former one was （1.648±0.416）×10^-3 mm^2/s,and the latter one was （1.256±0.320）×10^-3 mm^2/s. By ROC analyzing,the optimal threshold of ADC was 1.400×10^-3 mm^2/s,the sensitivity and specificity were 83.3%,74.1%,respectively. There was statistical differences between small cell lung cancer （SCLC） and non-small cell lung cancer （NSCLC） as well （ t=2.967,P =0.007）.The ADC value of SCLC was （1.064±0.196）×10^-3 mm^2/s,and that of NSCLC was （1.321±0.335）×10^-3 mm^2/s. The ADC value of primary pulmonary carcinoma （1.255±0.328）×10^-3 mm^2/s was slightly lower than that of metastatic tumors （1.263±0.280）×10^-3 mm^2/s,however the differences didn＇t have statistical significance（ t =0.063,P 〉0.05）. Conclusion Quantitative analysis of ADC values may help diagnose and distinguish pulmonary lesions,and also it provides a promising method for characterizing the pulmonary masses.

关 键 词：肺 磁共振成像 扩散加权成像 表观扩散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学] R563.9[医药卫生—临床医学]