多模态MRI在肺炎性结节与肺癌中的应用价值  

The Application Value of Multimodal MRI in the Diagnosis of Pulmonary Inflammatory Nodules and Lung Cancer

作　　者：贾艳荣[1] 张凤翔[1] 张芳[1] 吴奇飞 张美兰 张嘉伟 JIA Yan-rong;ZHANG Feng-xiang;ZHANG Fang;WU Qi-fei;ZHANG Mei-lan;ZHANG Jia-wei(Department of CT-MRI,Erdos Central Hospital,Erdos 017000,Inner Mongolia,China)

机构地区：[1]鄂尔多斯市中心医院CT-MRI室,内蒙古鄂尔多斯017000

出　　处：《中国CT和MRI杂志》2024年第7期53-55,共3页Chinese Journal of CT and MRI

基　　金：内蒙古医科大学科技百万工程联合项目(YKD2018KJBW(LH)094);内蒙古自治区卫生健康科技计划项目(202202371)。

摘　　要：目的探讨多模态MRI在肺炎性结节与肺癌中的应用价值。方法收集我院经病理或临床随访证实的肺炎性结节与肺癌患者各25例,所有病例均行胸部CT平扫及多模态MRI扫描,MRI序列包括轴位T_(1)WI、轴位T_(2)WI、轴位T_(2)WI压脂、多b值DWI扫描,多b值DWI序列b值设定为600、800、1000、1200、1500、2000s/mm^(2),并测量病灶不同b值的ADC值。采用卡方检验比较肺癌的CT及MRI征象。采用两独立样本的t检验或Mann-Whitney U检验分别比较两组不同b值的ADC值。运用MedCalc 11.4软件绘制ROC曲线,计算曲线下面积,采用Delong检验对不同b值的ADC值的ROC曲线诊断效能进行比较。结果肺炎性结节组与肺癌组在显示支气管狭窄或截断上有统计学差异(P<0.05),其余征象均无统计学差异(P>0.05)。肺炎性结节组在T_(1)WI上以等信号和低信号为主,T_(2)WI上以高信号为主;而肺癌组在T_(1)WI上以等信号和混杂信号为主,T_(2)WI上以高信号和混杂信号为主。肺炎性结节组与肺癌组不同b值的ADC值之间均有统计学差异(P<0.05),且肺癌组不同b值情况下,ADC值均低于肺炎性结节组;随着b值的升高,肺癌组ADC值下降显著。通过绘制不同b值ADC值的ROC曲线,得出b值1000的诊断价值最高,AUC为0.934(0.826-0.985),敏感度为96%,特异度为92%,诊断阈值为1.25×10^(-3)mm^(2)/s。结论多模态MRI在肺炎性结节与肺癌的鉴别诊断中有重要价值,能够为肺部疾病的诊断及治疗方式的选择提供更多信息。Objective To discuss the application value of multimodal MRI in the diagnosis of pulmonary inflammatory nodules and lung cancer.Methods Twenty five patients with pulmonary inflammatory nodules and 25 patients with lung cancer confirmed by pathology or clinical follow-up were collected.All patients underwent CT plain scanning and multimodal MRI scanning.MRI sequences included axial T_(1)WI,axial T_(2)WI,axial T_(2)WI lipid compression,and multi-b-value DWI scanning.The b value of multi-b-value DWI sequence was set as 600,800,1000,1200,1500,and 2000s/mm^(2).ADC values of the lesions under different b values were measured.Chi-square test was used to compare the CT and MRI signs of lung cancer.T test or Mann-Whitney U test of two independent samples were used to compare ADC values of two groups with different b values.MedCalc 11.4 software was used to draw the ROC curve and calculate the area under the curve.Delong test was used to compare the diagnostic efficiency of ROC curves of ADC values with different b values.Results There were statistical differences in bronchial stenosis or truncation between pulmonary inflammatory nodules group and lung cancer group(P<0.05),but no statistical differences in other signs(P>0.05).In the pulmonary inflammatory nodules group,isosignal and low signal were dominant on T_(1)WI,and high signal was dominant on T_(2)WI.In lung cancer group,isosignal and mixed signal were dominant on T_(1)WI,high signal and mixed signal were dominant on T_(2)WI.ADC values of pulmonary inflammatory nodules group and lung cancer group were statistically different with different b values(P<0.05),and ADC values of lung cancer group were lower than those of pulmonary inflammatory nodules group with different b values.With the increase of b value,ADC value in lung cancer group decreased significantly.By drawing the ROC curves of ADC values with different b values,it is found that b value 1000 had the highest diagnostic efficiency,with an AUC of 0.934(0.826-0.985),sensitivity of 96%,specificity of 92%,and the

关 键 词：炎性结节 肺癌 扩散加权成像 鉴别诊断 

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]