周围型肺癌的磁共振体素内不相干运动扩散加权成像  

MR intravoxel incoherent motion diffusion-weighted imaging in peripheral lung cancer

作　　者：雷永霞[1] 李新春[1] 万齐[1] 孙翀鹏[1] 邓宇[1] 钟志伟[1] 蒙秋华[1] 彭亚辉[2] 

机构地区：[1]广州医科大学附属第一医院放射科,广东广州510120 [2]北京交通大学电子信息工程学院,北京100044

出　　处：《中国医学影像技术》2015年第1期57-61,共5页Chinese Journal of Medical Imaging Technology

基　　金：广州医科大学科研基金(2012C31)

摘　　要：目的探讨磁共振体素内不相干运动扩散加权成像(IVIM-DWI)在周围型肺癌的可行性及诊断价值。方法收集CT发现肺部孤立性病变的患者38例,周围型肺癌30例,感染性肉芽肿8例。其中35例经病理证实,3例经临床资料证实。所有患者术前或治疗前均接受IVIM-DWI,b值为0、25、50、75、100、200、400、600、800、1000s/mm2,分别测量所有病灶的真实扩散系数(D)、灌注相关扩散系数(D*)及灌注分数(f)值并进行统计学分析。31例行CD34染色并计数微血管密度(MVD),并将D、D*及f值与MVD进行相关性分析。结果周围型肺癌的f值[(29.29±10.89)%]明显低于感染性肉芽肿[(46.10±12.92)%,P<0.01)];周围型肺癌D值、D*值与感染性肉芽肿差异无统计学意义(P均>0.05)。周围型肺癌和感染性肉芽肿的D值、D*值、f值与MVD计数均无明显相关性(P均>0.05)。f值的ROC曲线下面积为0.83,最佳阈值为38.00%,诊断周围型肺癌的敏感度为0.80,特异度为0.75。结论 IVIM-DWI技术可用于检查肺部孤立性病变,f值在周围型肺癌及感染性肉芽肿的鉴别诊断方面具有一定价值。Objective To explore possibility and diagnostic value of the MR intravoxel incoherent motion diffusion-weighted imaging（IVIM-DWI）in the peripheral lung cancer.Methods Thirty-eight patients（30cases of peripheral lung cancer,8cases of infectious granuloma）with pulmonary isolated lesions were found by CT,and 35 cases were confirmed by pathology and 3cases were confirmed by clinics.All cases were examined with IVIM-DWI sequence before operation or treatment.b-values was 0,25,50,75,100,200,400,600,800,1000s/mm^2 respectively.The parameters of diffusion coefficient（D）,diffusion coefficient from the perfused compartment（D＊）and perfusion fraction（f）of all lesions was calculated;31cases were stained by CD34 and counted micro-vessel density（MVD）,then correlation between D,D＊,fand MVD were analyzed.Results The value of f was significantly lower in peripheral lung cancer（[29.29±10.89]%）comparing with infectious granuloma（[46.10±12.92]%,P〈0.01）.There was no significant difference between peripheral lung cancer and infectious granuloma for D and D＊（P〉0.05）.The values of D,D＊,fand MVD of peripheral lung cancer and infectious granuloma were not significantly correlated（all P〉0.05）.The area under the ROC of the fvalues was 0.83,the cut-off of fvalues was 38.00%,the sensitivity and specificity in diagnosis of peripheral lung cancer was 0.80,0.75 respectively.Conclusion IVIM-DWI is reliable in pulmonary isolated lesions.fis helpful in distinguishing peripheral lung cancer from infectious granuloma.

关 键 词：肺肿瘤 扩散磁共振成像 体素内不相干运动 微血管密度 

分 类 号：R734.2[医药卫生—肿瘤] R445.2[医药卫生—临床医学]