DCE-MRI定量参数联合血清VEGF、ProGRP水平检测对肺部良恶性病变的鉴别诊断价值  

Value of DCE-MRI Quantitative Parameters Combined with Serum VEGF and ProGRP Levels in Differential Diagnosis of Benign and Malignant Lung Lesions

作　　者：韩树亮 杨洁 郭孟珂 徐珂 Han Shuliang;Yang Jie;Guo Mengke;Xu Ke(Medical Imaging Department of the First Affiliated Hospital of Henan University,Kaifeng,Henan 475000,China)

机构地区：[1]河南大学第一附属医院医学影像科,河南开封475000

出　　处：《哈尔滨医药》2024年第2期37-40,共4页Harbin Medical Journal

基　　金：河南省医学科技攻关计划项目(LHGJ20220654)。

摘　　要：目的探讨动态增强磁共振成像(DCE-MRI)定量参数联合血清血管内皮生长因子(VEGF)、胃泌素释放肽前体(ProGRP)水平检测对肺部良恶性病变的鉴别诊断价值。方法回顾性选取疑似肺癌患者95例,并根据穿刺活检病理结果,将患者分为良性病变(46例)及恶性病变(49例),分别纳入良性组、恶性组。比较两组DCE-MRI定量参数[速率常数(Kep)、容量转移常数(Ktrans)、血管外细胞外间隙容积比(Ve)]及血清VEGF、ProGRP水平,分析DCE-MRI定量参数联合血清VEGF、ProGRP水平检测对肺部恶性病变的诊断价值。结果恶性组形状不规则、边缘毛刺征、内部强化不均匀、早期增强率≥60%占比大于良性组(P<0.05);恶性组Kep、Ktrans、Ve值及血清VEGF、ProGRP水平高于良性组,且联合诊断肺部恶性病变的AUC为0.898,最佳诊断敏感度为91.84%,特异度为86.96%,约登指数为0.788。结论DCE-MRI定量参数Kep、Ktrans、Ve及血清VEGF、ProGRP水平与肺部恶性病变密切相关,联合检测具有一定诊断价值,可作为临床鉴别诊断肺部良恶性病变有效检查方案之一。Objective To evaluate the value of quantitative parameters of dynamic enhanced magnetic resonance imaging(DCE-MRI)combined with serum vascular endothelial growth factor(VEGF)and ProGRP levels in the differential diagnosis of benign and malignant lung lesions.Methods 95 patients with suspected lung cancer were retrospectively selected and divided into benign lesions(46 cases)and malignant lesions(49 cases)according to the biopsy results,and were included in the benign group and malignant group,respectively.The imaging findings of the two groups were compared.Quantitative parameters of DCE-MRI[rate constant(Kep),volume transfer constant(Ktrans),extracellular space volume ratio(Ve)]and serum levels of VEGF and ProGRP were compared between the two groups.To analyze the diagnostic value of DCE-MRI quantitative parameters combined with serum VEGF and ProGRP levels in malignant lung lesions.Results The proportion of irregular shape,edge burr sign,uneven internal enhancement and early enhancement rate≥60%in the malignant group was higher than that in the benign group(P<0.05).The levels of Kep,Ktrans,Ve and serum VEGF and ProGRP in the malignant group were higher than those in the benign group.The AUC for the combined diagnosis of malignant lung lesions was 0.898,the optimal diagnostic sensitivity was 91.84%,the specificity was 86.96%,and the Yoden index was 0.788.Conclusion Quantitative parameters Kep,Ktrans,Ve and serum VEGF and ProGRP levels of DCE-MRI are closely related to malignant lung lesions.The combined detection has certain diagnostic value,and can be used as an effective method for differentiating benign and malignant lung lesions.

关 键 词：动态增强磁共振成像 血管内皮生长因子 胃泌素释放肽前体 肺部病变 鉴别诊断 

分 类 号：R457.2[医药卫生—治疗学]