放射状K空间填充的自由呼吸容积内插序列对周围型实性肺占位形态学征象的显示价值  

The value of MR high resolution free-breathing radial VIBE in displaying the morphological characteristics of peripheral solid pulmonary masses

作　　者：党珊 师卫华 段海峰 马光明 于楠 韩冬[1] 张兆国 DANG Shan;SHI Wei-hua;DUAN Hai-feng;MA Guang-ming;YU Nan;HAN Dong;ZHANG Zhao-guo(The Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China;Shaanxi University of Chinese Medicine,Xianyang 712046,China)

机构地区：[1]陕西中医药大学附属医院医学影像科,咸阳712000 [2]陕西中医药大学,咸阳712046

出　　处：《磁共振成像》2018年第10期754-758,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:81701691)~~

摘　　要：目的通过比较MR放射状K空间填充的自由呼吸容积内插序列[free-breathing radial 3D fat-suppressed T1-weighted gradient echo(radial volumetric interpolated breath-hold examination),radial VIBE]与常规剂量CT对肺占位基本征象的显示,探讨radial VIBE用于评价周围型实性肺占位形态学征象的可行性。材料与方法前瞻性地纳入46例CT检查发现周围型实性肺占位的患者,共49个病灶,病灶大小约(3.87±1.91) cm,CT检查后48 h内行胸部MR检查。两名放射医师分别对MR及CT图像病灶形态学征象(分叶、毛刺、胸膜凹陷、棘突、空洞、空泡、晕征、纵隔淋巴结肿大及钙化)进行观察。CT图像按照征象显示与否分为两类,MR图像评估采用5分法。以CT作为参照标准,使用受试者工作特征曲线评估MR对肺占位形态学征象的显示能力。结果以CT为标准,radial VIBE对分叶征的显示敏感性及特异性分别为91.3%、100%;毛刺征敏感性及特异性分别为90.0%、78.9%;胸膜凹陷征敏感性及特异性分别为62.5%、76.0%;棘突征敏感性及特异性分别为91.1%、83.3%;空洞敏感性、特异性均为100%;空泡敏感性及特异性分别为90.0%、97.4%;晕征敏感性及特异性分别为50.0%、100%;纵隔淋巴结肿大敏感性及特异性分别为94.4%、90.3%;其中4例结节出现钙化,radial VIBE对其显示欠佳。结论 radial VIBE序列对周围型实性肺占位分叶征、毛刺征、棘突征、空洞、空泡及纵隔淋巴结肿大等征象显示较好,MR有望成为CT的补充手段来评估周围型实性肺占位的形态学征象。Objective:To evaluate initially the diagnosis capability of no radiationdose radial VIBE in observing the morphological characteristics of peripheral solid pulmonary masses,with the routine-dose computer tomography as a reference standard.Materials and Methods:Forty-six patients,49 peripheral solid pulmonary masses were prospectively enrolled.The average size of the masses was about(3.87±1.91)cm,standard dose CT and radial VIBE imaging were used.Two radiologists had observed MR and CT morphological characteristics of peripheral solid pulmonary masses(lobulation,speculation,pleural indentation,spinous process,cavitation,bubblelike attenuation,halo,mediastinal lymph node enlargement and calcification).According to whether the signs are displayed or not,CT images are divided into two kinds,and the MR images are evaluated by 5 point visual scoring system.With CT as a reference standard,the ROC was used to evaluate the display capability of radial VIBE in displaying the morphological appearance of peripheral solid pulmonary masses.Results:Compared with CT,the sensitivity and specificity of radial VIBE in displaying morphological characteristics were as follows:lobulation 91.3%and 100%,respectively;speculation 90%and 78.9%,respectively;pleural indentation 62.5%and 76%,respectively;spinous process 91.1%and 83.3%,respectively;cavitation 100%and 100%;bubblelike attenuation 90%,97.4%,respectively;halo 50%,100%,respectively;enlarged mediastinal lymph node 94.4%and 90.3%,respectively;radial VIBE has not found these 4 cases which have calcification in CT.Conclusions:Although not as efficient as CT,the morphological characteristics of peripheral solid pulmonary masses were well visualized on radial VIBE images,such as lobulation,spiculation,spinous process,cavitation,bubblelike attenuation and mediastinal lymph node enlargement,which can be used to evaluate the morphological characteristics of peripheral solid pulmonary masses.However,radial VIBE was less effective in displaying calcification.

关 键 词：电子计算机断层扫描 周围型实性肺占位 形态学征象 磁共振成像 

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]