全病变表观扩散系数直方图对肺部孤立性实性病变的鉴别诊断  

Histogram of Whole-Lesion Apparent Diffusion Coefficient for the Differential Diagnosis of Solitary Solid Lesions in the Lung

作　　者：耿广[1] 李臻 吴欣娟 李雯[1] 郭海荣 王新举[1] GENG Guang;LI Zhen;WU Xinjuan;LI Wen;GUO Hairong;WANG Xinju(Department of Radiology,Hebei Province Chest Hospital,Shijiazhuang 050000,China;不详)

机构地区：[1]河北省胸科医院影像科,河北石家庄050000 [2]石家庄市二院心内科,河北石家庄050000 [3]石家庄市妇幼保健院妇产科,河北石家庄050000

出　　处：《中国医学影像学杂志》2020年第7期513-516,519,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨磁共振扩散加权成像(DWI)中全病变表观扩散系数(ADC)直方图对肺部孤立性实性病变的鉴别诊断价值。资料与方法收集肺部孤立性实性病变64例,其中恶性42例、良性22例。所有患者均在治疗前接受不同b值(0、400、800 s/mm^2)肺部DWI检查。测量全病变ADC直方图参数,包括偏度、峰度、熵、体积、ADC平均数、中位数、标准差和多组ADC百分位数。分析不同病理性质患者各项参数的差异。绘制受试者工作特征(ROC)曲线,筛选具有最高诊断效能的参数。全部病例按病理亚型分为腺癌、鳞癌、小细胞癌、其他恶性肿瘤、结核和肺炎,并进行组间比较。结果肺部恶性病变的峰度、偏度、ADC标准差和ADC第80、85、90、95百分位数均小于良性病变,差异均有统计学意义(P<0.05)。偏度诊断效能最高,ROC曲线下面积为0.726。腺癌组峰度、偏度、ADC标准差以及ADC第80、85、95百分位数均小于肺炎组,差异均有统计学意义(P<0.05)。结论全病变ADC直方图对鉴别肺部孤立性实性病变有一定的应用价值,其中偏度诊断效能最高。Purpose To investigate the value of whole-lesion apparent diffusion coefficient(ADC)histogram of diffusion-weighted imaging(DWI)in the differentiation of solitary solid pulmonary lesions.Materials and Methods Sixty-four solitary solid pulmonary lesions were collected,including 42 malignant and 22 benign lesions.All patients received pulmonary diffusion-weighted imaging(DWI)before treatment,including 3 b values:0,400 and 800 s/mm2.ADC histogram parameters of the whole lesions were measured,including skewness,kurtosis,entropy,mean ADC value,median value,standard deviation,lesion volume and several ADC percentiles.The differences between benign and malignant lesions were compared,receiver operating characteristic(ROC)curve was drawn and parameters with the highest diagnostic efficiency were chosen out.All patients were subdivided into six groups according to pathological types:adenocarcinoma,squamous cell carcinoma,small cell carcinoma,other malignant tumors,tuberculosis and pneumonia.Differences among groups were compared.Results Kurtosis,skewness,mean ADC value,ADC standard deviation,and ADC 80th,85th,90th,95th of malignant lung lesions were significantly lower than those of benign lesions(P<0.05).The parameter with the highest diagnostic efficiency was skewness,with area under curve of 0.726.Kurtosis,skewness,ADC standard deviation and ADC 80th,85th,95th of adenocarcinoma group were statistically lower than those of pneumonia group(P<0.05).Conclusion The whole-lesion ADC histogram has a certain value in the differentiation of benign and malignant pulmonary solitary solid lesions.Skewness has the highest diagnostic efficiency.

关 键 词：肺肿瘤 磁共振成像 扩散加权成像 表观扩散系数 诊断 鉴别 

分 类 号：R730.42[医药卫生—肿瘤] R734.2[医药卫生—临床医学]