对比增强SWI对不同病理类型肺癌脑转移瘤的诊断价值  

The value of contrast-enhanced SWI on brain metastases of different pathological types of lung cancer

作　　者：吴立业[1] 罗文明 蒋锡丽 黄子龙 刘军[2] WU Li-ye;LUO Wen-ming;JIANG Xi-li(Department of Radiology,Hunan Provincial Brain Hospital(Hunan Second People's Hospital),Changsha 410007,China)

机构地区：[1]湖南省脑科医院(湖南省第二人民医院)放射科,长沙410007 [2]中南大学湘雅二医院放射科,长沙410011

出　　处：《放射学实践》2024年第1期55-59,共5页Radiologic Practice

基　　金：湖南省科技厅临床医疗技术创新引导项目(NO:2020SK50805)。

摘　　要：目的:探讨对比增强磁敏感加权成像(CE-SWI)与常规对比增强T 1WI成像(CE-T 1WI)对不同病理类型肺癌脑转移瘤的检出率差异,分析脑转移瘤内出现对比剂诱导相移(CIPS)与原发性肺癌病理类型间的关联性。方法:搜集经病理证实的79例原发性肺癌患者,其中腺癌组40例,鳞癌组18例,小细胞癌组21例,均行颅脑MR常规平扫、SWI、CE-T 1WI及CE-SWI检查,比较CE-SWI与CE-T 1WI检出的脑转移瘤数目及转移瘤内是否存在CIPS,转移灶经3个月后随访证实。结果:CE-T 1WI与CE-SWI对腺癌脑转移瘤的检出率差异有统计学意义(χ^(2)=5.05,P=0.025),对鳞癌(χ^(2)=0.00,P=1.000)与小细胞癌(χ^(2)=0.27,P=0.603)脑转移瘤的检出率差异无统计学意义。腺癌组、鳞癌组、小细胞癌组三组间CIPS阳性率差异有统计学意义(χ^(2)=11.13,P=0.004),其中鳞癌组与腺癌组(χ^(2)=11.08,P=0.001)、鳞癌组与小细胞癌组(χ^(2)=8.26,P=0.004)间差异有统计学意义,腺癌组与小细胞癌组间差异无统计学意义(χ^(2)=0.131,P=0.717)。结论:CE-SWI对肺腺癌脑转移瘤的检出较CE-T 1WI更有优势。肺腺癌、小细胞癌脑转移瘤的CIPS阳性率较鳞癌显著增高,CE-SWI可为肺癌脑转移瘤MRI检查常规序列的有利补充,为临床诊疗提供更多重要参考信息。Objective:To evaluate the difference between contrast-enhanced susceptibility weighted imaging(CE-SWI)and conventional contrast-enhanced T 1 weighted imaging(CE-T 1WI)in the detection rate of brain metastases from different pathological types of lung cancer,and to study the correlation between contrast-induced phase shifts(CIPS)in brain metastases and pathological types of primary lung cancer.Methods:Seventy-nine patients with primary lung cancer confirmed by pathology were included,including 40 cases with adenocarcinoma,18 cases with squamous cell carcinoma and 21 cases with small cell carcinoma.All patients underwent MRI scan which included plain T 1WI and SWI,CE-T 1WI,and CE-SWI.The number of brain metastases detected by CE-SWI and CE-T 1WI and the presence of CIPS in each metastatic tumor were recorded and compared between groups.The metastatic tumors were confirmed by follow-up after 3 months.Results:The CE-T 1WI and CE-SWI detection rate of adenocarcinoma brain metastases was significantly different(χ^(2)=5.05,P=0.025).No significant difference was found in the detection rate in squamous cell carcinoma group(χ^(2)=0.00,P=1.000)and small cell carcinoma group(χ^(2)=0.27,P=0.603).The positive rate of CIPS among the three groups was significantly different(χ^(2)=11.13,P=0.004).Furthermore,there was significant difference between the squamous cell carcinoma group and the adenocarcinoma group(χ^(2)=11.08,P=0.001)and between the squamous cell carcinoma group and small cell carcinoma group(χ^(2)=8.26,P=0.004).However,there was no significant difference between the adenocarcinoma group and the small cell carcinoma group(χ^(2)=0.131,P=0.717).Conclusion:CE-SWI is superior to CE-T 1WI in detecting brain metastases of lung adenocarcinoma.The positive rate of CIPS in brain metastases of lung adenocarcinoma and small cell carcinoma was significantly higher than that of squamous cell carcinoma.CE-SWI can be a beneficial supplement to the routine MRI sequences to detect brain metastases of lung cancer,and can provide

关 键 词：肺肿瘤 脑转移瘤 磁敏感加权成像 磁共振成像 对比剂诱导相移 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]