纵膈、肺门良恶性肿块的MR HASTE影像特征及诊断模型构建  

Imaging Characteristics of MR HASTE and Construction of Diagnostic Model in Patients with Benign and Malignant Masses of Mediastinum and Hilus Pulmonis

作　　者：郭玲 王进才 段俊 GUO Ling;WANG Jin-cai;DUAN Jun(Department of Radiological Interventions,Shijiazhuang Fourth Hospital,Shijiazhuang 050011,Hebei Province,China;Department of Imaging,Shijiazhuang People's Hospital,Shijiazhuang 051130,Hebei Province,China)

机构地区：[1]石家庄市第四医院放射介入科,河北石家庄050011 [2]石家庄市人民医院影像中心,河北石家庄051130

出　　处：《中国CT和MRI杂志》2024年第12期60-63,共4页Chinese Journal of CT and MRI

基　　金：河北省卫生健康委员会指导项目(20221709)。

摘　　要：目的探讨纵膈、肺门良恶性肿块患者的核磁共振(MR)单次激发快速扫描(HASTE)影像特征,并构建相关诊断模型。方法选取2021年10月至2023年5月本院收治的102例纵膈、肺门肿块患者,随机数表法按7:3比例分为训练集72例和测试集30例,均接受MR HASTE、增强CT扫描和病理检查。比较训练集和测试集纵膈、肺门肿块患者病理诊断结果;分析纵膈、肺门良恶性肿块的MR HASTE影像特征;以病理诊断为“金标准”,分析训练集与测试集不同方法诊断纵膈、肺门肿块良恶性与病理诊断结果的一致性;建立MR HASTE模型、MSCT增强模型和MR HASTE+MSCT增强联合模型,受试者工作特征曲线(ROC)评价各模型诊断纵膈、肺门恶性肿块的效能;Delong检验评估模型间效能的差异,Hosmer-Lemeshow检验联合模型拟合度。结果训练集72例纵膈、肺门肿块患者经穿刺病理检查确诊恶性病变62例,良性肿块10例;测试集30例确诊恶性病变24例,良性病变6例。纵膈、肺门肿块良性肿块的MR HASTE影像特征表现病变形态规则,边界清晰,病变内信号均匀,周边无转移表现,T2WI图像上多暗少亮;恶性肿块的影像特征表现病变形态不规则,边界不清晰,内部信号呈不均匀高、等、低混杂信号,病灶内斑点状、小片状高信号。训练集中MR HASTE检查、MSCT增强和MR HASTE+MSCT增强诊断纵膈、肺门肿块良恶性的灵敏度为87.10%、91.94%和96.77%,Kappa值为0.536、0.498和0.768。经ROC曲线和DeLong检验、Hosmer-Lemeshow检验,测试集联合模型纵膈、肺门恶性肿块的AUC值优于MR HASTE模型、MSCT增强模型单独检测(P<0.05)。结论纵膈、肺门良性肿块MRHASTE影像特征表现病变形态规则,边界清晰,病变内信号均匀,周边无转移表现,恶性肿块形态不规则,边界不清,内部信号呈不均匀混杂信号,病灶内斑点状高信号,MR HASTE+MSCT增强联合诊断模型对肿块良恶性的诊断效能最高。Objective To explore imaging characteristics of magnetic resonance(MR)half-Fourier acquisition single-shot turbo spin-echo(HASTE)and construct the relevant diagnostic model in patients with benign and malignant masses of mediastinum and hilus pulmonis.MethodsA total of 102 patients with masses of mediastinum and hilus pulmonis in the hospital were enrolled between October 2021 and May 2023.According to random number table method,they were divided into training set(72 cases)and test set(30 cases).All patients underwent MR HASTE,enhanced CT scan and pathological examination.The results of pathological diagnosis were compared between training set and test set.Imaging characteristics of MR HASTE in patients with benign and malignant masses of mediastinum and hilus pulmonis were analyzed.Taking pathological diagnosis as the golden standard,the consistency between different methods and pathological examination in the diagnosis of mediastinum and hilus pulmonis masses was analyzed.MR HASTE model,MSCT enhanced model and MR HASTE+MSCT enhanced model were constructed,and their diagnostic efficiency for malignant masses was evaluated by receiver operating characteristic(ROC)curves.The differences in diagnostic efficiency of different models were evaluated by Delong test.The fit of the combined model was detected by Hosmer-Lemeshow.ResultsPathological examination showed that in training set,there were 62 cases with malignant lesions and 10 cases with benign masses.In test set,there were 24 cases with malignant lesions and 6 cases with benign lesions.Imaging characteristics of MR HASTE in benign masses were as follows:regular lesion morphology,clear boundary,even signals in lesions,no peripheral metastasis,more dark and less brightness in T2WI images.Imaging characteristics of MR HASTE in malignant masses were as follows:irregular lesion morphology,unclear boundary,uneven and high,equal or low mixed signals in lesions,spot-like and strip-like high signals in lesions.In training set,sensitivity and Kappa values of MR HASTE,MSC

关 键 词：纵膈 肺门 肿块 良恶性 核磁共振 单次激发快速扫描 影像特征 诊断模型 

分 类 号：R445.2[医药卫生—影像医学与核医学]