肺良恶性实性病变MRI动态增强与螺旋CT诊断效能比较分析  

Diagnostic value of dynamic contrast-enhanced MR imaging versus spiral computed tomography in solitary pulmonary lesions

作　　者：何建勋[1] 俞家熙[1] 万齐[1] 邓颖诗[1] 邹乔[1] 钟志伟[1] 李新春[1] 

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

出　　处：《广州医科大学学报》2015年第4期26-30,共5页Academic Journal of Guangzhou Medical University

基　　金：广州市科技计划项目(201510010234);广州市医药卫生科技项目(20151A011066)

摘　　要：目的:探讨MRI动态增强成像(DCE-MRI)在肺孤立性良恶性实性病变中的诊断价值。方法:采用3.0 T MRI对2014年7月-2015年2月本科室胸部CT发现的56例肺孤立实性病变进行动态增强扫描,其中良性病变12例,周围型肺癌44例,分别测量病灶的最大相对强化比、最大强化值,获得时间-信号曲线(TIC),比较肺良恶性病变的ROC曲线下面积(AUC),并与CT诊断结果进行比较。结果:周围型肺癌与良性病变的最大相对强化比差异无统计学意义(P>0.05);周围型肺癌与良性病变的最大强化值分别为108.26±30.03和79.01±32.46(P<0.05)。最大强化值的ROC曲线下面积为0.74,最大强化值96.35时诊断效能最高,敏感性和特异性分别为72.72%和75.00%。周围型肺癌的时间-信号强度曲线以A和B型曲线类型为主,占84.09%(37/44);良性病变以C和D型曲线类型为主,占58.33%(7/12)。MRI与CT诊断准确率分别为:80.36%(45/56)及83.93%(47/56)(P>0.05)。结论:病灶动态增强MRI最大强化值及时间-信号强度曲线对肺良恶性实性病变的鉴别有一定价值。Objective： To investigate the diagnostic value of dynamic contrast enhanced MR imaging（ DCEMRI） in the diagnosis of benign and malignant lesions of the lung. Methods： A total of 56 patients with solitary pulmonary lesions（ including 44 with peripheral lung cancer and 12 with benign lesions） detected by chest CT scan in our department between July 2014 and February 2015 were enrolled in this prospective study. The 3. 0T DCE-MRI images were analyzed by measuring the max relative enhancement values and the max enhancement values. The time-signal intensity curve was generated. The area under the ROC curve（ AUC） of benign and malignant lung lesions were calculated and compared with diagnostic accuracy of CT. Results： There was no significant difference in the max relative enhancement values between peripheral lung cancers and benign lesions（ P〈0. 05）. The maximum enhancement value was 108. 26 ± 30. 03 in peripheral lung cancers versus 79. 01 ±32. 46 in the benign lesions,with a statistically significant difference between the both（ P〈0. 05）. The AUC of the maximum enhancement values was 0. 74. With a cut-off value of 96. 35,best diagnostic efficiency of DCEMRI was achieved,yielding 72. 72% sensitivity and 75. 00% specificity. The time-intensity curve of peripheral lung cancer were predominantly featured by types A and B curves which accounted for 84. 09% of the total images（ 37 /44）,whereas the curve of benign lesions by types C and D curves which accounted for 58. 33% of the total（ 7 /12）. The diagnostic accuracy of MRI and CT was 80. 36%（ 45 /56） and 83. 93%（ 47 /56）respectively（ P〈0. 05）. Conclusion： The maximum enhancement value and time signal intensity of DCE-MRI curve will be helpful in the differentiation of benign and malignant lesions of the lung.

关 键 词：动态增强MRI 肺孤立性病变 电子计算机体层摄影 

分 类 号：R734.2[医药卫生—肿瘤]