磁共振表观扩散系数在CT引导下肺肿块穿刺活检术病灶定位中的应用  

Application of magnetic resonance apparent diffusion coefficient in lesion localization during CT-guided lung mass aspiration biopsy

作　　者：徐龙 朱晓平 张丽 李鑫 段海峰 XU Long;ZHU Xiaoping;ZHANG Li;LI Xin;DUAN Haifeng(School of Medical Technology,Shaanxi University of Chinese Medicine,Xianyang 712046,China;不详)

机构地区：[1]陕西中医药大学医学技术学院,陕西咸阳712046 [2]新疆伊犁哈萨克自治州友谊医院CTMR科,新疆伊犁835000 [3]陕西中医药大学附属医院医学影像科,陕西咸阳712000

出　　处：《山东医药》2025年第3期22-25,45,共5页Shandong Medical Journal

基　　金：陕西省教育厅青年创新团队科学研究计划项目(23JP035)。

摘　　要：目的分析磁共振(MRI)表观扩散系数(ADC)在CT引导下肺肿块穿刺活检术病灶定位中的应用价值。方法选择行首次穿刺活检术的肺肿块患者22例、行二次穿刺活检术的肺肿块患者10例,穿刺前均行胸部MRI检查,获取b值为800 s/mm^(2)的弥散加权成像(DWI)图像及与之对应的ADC图像。行首次穿刺术的患者将DWI图像上低信号区域和ADC图像上高信号区域视为病变坏死区域(A区),DWI图像上高信号区域和ADC图像上低信号区域视为病变活性区域(B区);行二次穿刺术的患者以首次穿刺的病理阴性区域为A区,二次穿刺的病理阳性区域为B区;比较患者A、B区的ADC。CT引导下穿刺活检术中分别在A、B区获取肺组织,HE染色后分析病理结果,比较A、B区的病理阳性率及阴性率。结果A、B区ADC分别为1.32(1.21,1.40)×10^(-3) mm^(2)/s、0.85(0.76,0.95)×10^(-3) mm^(2)/s,二者比较P<0.05。A区病理诊断为良性病变27例(84.38%)、恶性病变5例(15.62%),B区病理诊断为良性病变3例(9.37%)、恶性病变29例(90.63%),其中B区的3例良性病变在A区病理结果也为良性;A区病理阳性率18.75%(6/32)、阴性率81.25%(26/32),B区病理阳性率100%(32/32),A区病理阳性率低于B区(P<0.05)。结论选择穿刺前胸部MRI显示ADC较低的区域作为穿刺靶点区域,有助于提高肺肿块患者CT引导下行穿刺活检术的病理准确性。Objective To analyze the application value of magnetic resonance apparent diffusion coefficient(ADC)in lesion localization during CT-guided percutaneous biopsy of lung masses.Methods Twenty-two patients with first puncture biopsy and 10 patients with second puncture biopsy of lung masses were selected,and chest magnetic resonance imaging(MRI)was performed before puncture,and diffusion-weighted imaging(DWI)image with b-value of 800 s/mm^(2) and the corresponding ADC image were obtained.For patients undergoing first puncture,low-signal areas on the DWI and high-signal areas on the ADC images were regarded as the necrotic lesion area(area A),while high-signal areas on the DWI images and low-signal areas on the ADC images were considered as lesion active area(area B).For patients undergoing a second puncture,the pathologically negative region identified in their first biopsy was designated as area A,while the pathologically positive region from the second biopsy was labeled as area B.The ADC values of areas A and B were compared.Lung tissues were obtained from both areas via CT-guided percutaneous biopsy.Pathological analysis was performed after HE staining,and the rates of pathological positivity and negativity in the two areas were evaluated.Results The ADC values in the areas A and B were 1.32(1.21,1.40)×10^(-3) and 0.85(0.76,0.95)×10^(-3) mm^(2)/s,respectively,with statistically significant differences between these two groups(P<0.05).In the area A,27 cases(84.38%)were pathologically diagnosed as benign lesions and 5 cases(15.62%)as malignant lesions.In the area B,3 cases(9.37%)were diagnosed as benign lesions and 29 cases(90.63%)as malignant lesions.The 3 cases with benign lesions in area B were also diagnosed as benign in area A.Pathologically positive rate in the area A was 18.75%(6/32)and negative rate was 81.25%(26/32),while the pathologic positive rate in the area B was 100%(32/32),and the pathologically positive rate in the area A was lower than that in the area B(P<0.05).Conclusion Selecting the area wi

关 键 词：表观扩散系数 磁共振成像 弥散加权成像 肺部肿块 穿刺活检术 

分 类 号：R445.2[医药卫生—影像医学与核医学]