磁化转移成像与扩散加权成像对肺部良、恶性结节/肿块鉴别诊断价值的对比研究  

Magnetization Transfer and Diffusion-Weighted Imaging in the Differential Diagnosis of Malignant and Benign Pulmonary Lesions: A Comparison Study

作　　者：党珊 韩冬 马光明 郭炎兵 杨祺 于楠 于勇[1,2] 段海峰 DANG Shan;HAN Dong;MA Guangming(Department of Radiology,Affiliated Hospital of Shaanxi University of traditional Chinese Medicine,XianYang,Shanxi Province 712000,P.R.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：《临床放射学杂志》2021年第11期2114-2117,共4页Journal of Clinical Radiology

基　　金：陕西中医药大学创新团队资助项目(编号:2019-QN09)。

摘　　要：目的探讨磁化转移成像(MTI)和扩散加权成像(DWI)在鉴别肺部良、恶性病变中的价值。方法本研究共纳入66例疑似肺癌患者,女18例,男48例;年龄29~89岁。均经病理证实,良性25例,恶性41例。DWI和MTI图像由两名放射科医师独立评估。计算表观扩散系数(ADC)及磁化传递率(MTR)。计算组内相关系数,以观察两名放射科医师测量结果的一致性。采用Mann-Whitney U检验比较组间差异。采用二元逻辑回归分析评价MR功能序列对肺良、恶性结节/肿块的鉴别诊断价值。绘制受试者工作特征曲线(ROC)评价单纯MTR、ADC及联合MTR和ADC值对肺良、恶性结节/肿块的鉴别诊断效能。结果两名放射科医师测量的MTR和ADC值的一致性分别为0.927和0.944。组间MTR和ADC值差异有统计学意义。MTR和ADC阈值分别为18.73%和1069×10^(-6)mm^(2)/s。MTR联合ADC的敏感度及曲线下面积(AUC)高于单独ADC或单独MTR;MTR的敏感度低,特异度最高。恶性病变ADC值低于良性病变,MTR值高于良性病变。结论MTI鉴别肺良、恶性结节/肿块的特异度高。MTR联合ADC可提高肺病灶的鉴别诊断准确率。Objective The aim of the study was to explore the value of magnetization transfer(MT)and diffusionweighted imaging(DWI)in differentiating malignant from benign pulmonary lesions.Methods A total of 66 patients(18 female and 48 males;age range,29-89 years),including 25 benign and 41 malignant cases,wereenrolled.The DWI and MT images were independently evaluated by two radiologists.The apparent diffusion coefficient(ADC)and the MT ratio(MTR)were calculated.The intraclass correlation coefficient was computed to investigate the consistency of the measurements between the two radiologists.The Mann-Whitney U test was performed to compare differences between groups.A multivariate logistic regression analysis was conducted to evaluate the diagnostic value of functional information.The receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic efficacy of MTR-only,ADC-only,and combined MTR and ADC values for benign and malignant pulmonary lesions.Results The consistency of MTR and ADC values measured by the two radiologists was 0.927 and 0.944,respectively.The difference in MTR and ADC values between groups was statistically significant.The MTR and ADC thresholds were 18.73%and 106910^(-3)mm^(2)/s,respectively.The area under the curve and sensitivity of combined MTR and ADC was higher than that of ADC only or MTR only.MTR has the lowest sensitivity and the highest specificity.Malignant lesions showed lower ADC and higher MTR values than benign lesions.Conclusion Magnetic transfer imaging has high specificity in differentiating benign and malignant pulmonary nodules/masses.The combination of MTR and ADC can help improve the accuracy of differentiation of pulmonary nodules/masses.

关 键 词：肺结节/肿块 磁化转移成像 扩散加权成像 磁化转移率 表观扩散系数 

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]