MR扩散加权成像鉴别肺良恶性病变  

Differentiation of pulmonary benign and malignant lesions with diffusion-weighted MR imaging

作　　者：陈光祥[1] 屈春晖[2] 郑婷[1] 韩福刚[1] 唐光才[1] 杨述根[1] 傅家庆[1] 

机构地区：[1]泸州医学院附属医院放射科,四川646000 [2]临沂市人民医院放射科,山东276000

出　　处：《放射学实践》2013年第7期763-766,共4页Radiologic Practice

摘　　要：目的:探讨肺部良恶性病变的DWI表现及ADC值鉴别肺部良恶性病变的价值。方法:将行胸部MRI及DWI检查的肺内有直径1cm以上的结节、肿块或实性病变的64例共76个病灶作为研究对象,全部病例均经病理证实。分析病变的DWI表现,对病变进行ADC值定量分析,比较肺良恶性病变及不同组织学类型肺癌ADC值的差异。结果:恶性病变DWI上主要表现为不规则的高信号结节或肿块,良性病变主要表现为等、稍高信号的结节或肿块。恶性病变组ADC值为(1.241±0.316)×10-3 mm2/s,良性病变组ADC值为(1.819±0.409)×10-3 mm2/s,良恶性病变组ADC值的差异有高度统计学意义(P<0.001)。中央型肺癌瘤灶实质的ADC值为(1.237±0.251)×10-3 mm2/s;周围型肺癌瘤灶实质的ADC值为(1.254±0.196)×10-3 mm2/s,两者间差异无统计学意义(P>0.05)。腺癌ADC值与鳞癌、大细胞癌、小细胞癌及肉瘤样癌ADC值差异有统计学意义(P<0.05),腺癌ADC值高于其它病理类型。结论:DWI实现了肺部病变ADC值的定量分析,有望成为肺部良恶性病变鉴别诊断的一种新方法,是常规MRI检查的一个有益补充。Objective：To study the diffusion-weighted imaging （DWI） findings in pulmonary benign and malignant le sions and the value of apparent diffusion coefficient （ADC） to differentiate pulmonary benign or malignant lesions. Methods： Sixty-four patients with 76 lesions 〉lcm in diameter of pulmonary nodules,masses or solid lesions were enrolled for MRI and DWI examination. All cases were pathologically confirmed. The characteristics of DWI of the lesions were analyzed. The ADC values of pulmonary lesions were quantitatively analyzed to differentiate the benign and malignant lesions with diffe rent histological types. Results： On DWI images, the malignant tumors mainly displayed irregular hyperintense nodules or masses, while the benign lesions mainly showed isointense or slightly hyperintense nodule or mass. The ADC values of ma lignant and benign tumors was （1. 241＋0. 316）×10^-3 and （1.819＋0.409） ×10^-3mm^2/s,respectively, with statistical significance （P〈0. 001）. The ADC values of central and peripheral lung cancer was （1. 237＋0. 251）×10^-3 and （1.254＋0. 196） × 10^-3mm^2/s respectively, with no statistical difference （P〉0.05）. The ADC values of adenocarcinoma had statisti-cal significant difference when compared to squamous cell carcinoma, small cell lung carcinoma, large cell carcinoma and sar-comatoid carcinoma （P〈0.05）. The ADC values of adenocarcinoma were higher than the other pathological types. Conclu-sion：DWI provides a quantitative analysis of ADC values in pulmonary lesions and it is expected to become a new method to differentiate pulmonary benign or malignant lesions. Therefore DWI is an useful supplement to conventional MR imaging.

关 键 词：磁共振成像 扩散加权成像 肺肿瘤 结核瘤 炎性假瘤 

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]