MRI扩散加权成像对肺内病变定性诊断的临床运用及病理对照分析  

The Study of MRI Diffusion Weighted Imaging in Qualitative Diagnosis for Pulmonary Lesion and Pathological Analysis

作　　者：封俊[1] 董兴祥[1] 陈龙[1] 张莹[1] 刘一帆[1] 丁莹莹[1] 胡早秀[2] FENG Jun;DONG Xing-xiang;CHEN Long;ZHANG Ying;LIU Yi-fan;DING Ying-ying;HU Zao-xiu(Department of Radiology,the 3rd Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital,Kunming 650118,Yunnan Province,China;Department of Pathology,the 3rd Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital,Kunming 650118,Yunnan Province,China)

机构地区：[1]昆明医科大学第三附属医院(云南省肿瘤医院)放射科,云南昆明650018 [2]昆明医科大学第三附属医院(云南省肿瘤医院)病理科,云南昆明650018

出　　处：《中国CT和MRI杂志》2022年第6期52-55,共4页Chinese Journal of CT and MRI

基　　金：云南省教育厅研究基金课题(2020J0202)。

摘　　要：目的探讨磁共振扩散加权成像DWI对肺内检出病变定性评估及鉴别诊断能力及临床运用价值。方法前瞻性对47例肺内检出病变进行胸部MRI扫描及扩散加权成像检查,回顾分析经手术、纤支镜及病理证实的肺内病变的临床、病理资料,分析其MR表现及扩散加权成像特点,ADC值与病理诊断及病变内细胞密集度的相关性。结果47例病变均为单发病变,10例为良性病变,37例为恶性肿瘤。良性结节组ADC值(1.27±0.23)×10^(-3)mm^(2)/s,恶性结节组ADC值(0.81±0.18)×10^(-3)mm^(2)/s。统计学分析,单因素分析中,采用χ^(2)检验,病变的良、恶性与ADC值具有相关性,χ^(2)=27.1,P<0.001;多因素分析中,只有病变良、恶性与ADC值相关,P<0.001。良性组病变内细胞排列、密集程度均低于肺癌组。结论磁共振扩散加权成像ADC值对肺内病变具有一定的定性评估及鉴别诊断的能力,有助于辅助CT对肺内病变进一步定性诊断,提高影像的综合诊断能力。Objective To investigate the clinical value of MRI diffusion weighted imaging in the qualitative diagnosis for pulmonary lesion.Methods 47 patients with pulmonary lesions were prospectively collected for chest MRI diffusion-weighted imaging.The pathological results of pulmonary lesions were confirmed by surgery or bronchoscopy,and the clinical and pathological characteristics were analyzed.The MRI manifestations and diffusion-weighted imaging characteristics of the lesions were analyzed.The correlation between ADC value and pathological diagnosis,cell density was analyzed.Results All 47 cases were solitary lesions,10 cases are benign and 37cases are malignancy.The mean ADC values were(1.27±0.23)×10^(-3)mm^(2)/s for benign tumors and(0.81±0.18)×10^(-3)mm^(2)/s for malignant tumors,respectively.In univariate analysis,the benign and malignant lesions were correlated with ADC values,the chi-square value is 27.1,and the P<0.001 by chi-square test.In the multivariate analysis,only the benign and malignant lesions were related to the ADC value,and the P<0.001.The arrangement and density of cells in the benign lesion group were lower than those in the malignant lesion group.Conclusion The ADC value of MRI diffusion weighted imaging has certain qualitative evaluation and differential diagnosis for lung lesions,which is helpful to assist CT in the qualitative diagnosis of lung lesions and improve the comprehensive diagnostic ability of imaging.

关 键 词：肺 扩散加权图像 ADC值 磁共振图像 

分 类 号：R445.2[医药卫生—影像医学与核医学]