【摘要】：目的:分析不同b值下病變的彌散加權(quán)成像技術(shù)(diffusion-weighted imaging,DWI)信號(hào)特點(diǎn)及其表面擴(kuò)張系數(shù)(apparent diffusion coefficient,ADC),探討其在肺部腫瘤MRI中的應(yīng)用價(jià)值。方法 :收集37例CT發(fā)現(xiàn)并經(jīng)病理或臨床隨訪證實(shí)肺部腫塊,行肺部常規(guī)MRI序列以及不同b值(500、800、1 000 s/mm2)DWI。在病灶最大徑層面上,分別測量各b值下病變的DWI信號(hào)強(qiáng)度、ADC值;通過受試者操作特征曲線(receiver operating characteristic curve,ROC),分析最佳b值及ADC值對肺部腫塊的鑒別診斷作用;分析病灶DWI信號(hào)大小、ADC值與病理類型的關(guān)系。結(jié)果:(1)肺部良性腫塊DWI呈等低信號(hào)或低信號(hào),大多數(shù)惡性腫塊DWI呈現(xiàn)等信號(hào)或高信號(hào)。(2)良性腫塊在b值為500、800、1 000 s/mm2時(shí),ADC值分別為(2.142±0.560)×10~(-3)、(1.746±0.499)×10~(-3)、(1.457±0.374)×10~(-3)mm2/s;惡性腫塊在b值為500、800、1 000 s/mm2時(shí),ADC值分別為(1.499±0.298)×10~(-3)、(1.274±0.230)×10~(-3)、(1.179±0.176)×10~(-3)mm2/s。(3)3種b值對良惡性腫塊的ADC值差異均有統(tǒng)計(jì)學(xué)意義(t=4.637,P0.001;t=3.695,P0.001;t=3.097,P0.004)。(4)3組b值ROC曲線下面積(AUC)分別為0.869、0.794和0.765,AUC0.5,可以作為良惡性腫塊鑒別診斷的有效指標(biāo),其中以500 s/mm2時(shí)所測ADC值的曲線下面積最大,ADC值良惡性鑒別閾值取1.475×10~(-3)mm2/s時(shí),診斷作用最高,敏感性為0.833、特異性為0.773、約登指數(shù)0.606。結(jié)論:DWI信號(hào)強(qiáng)度及ADC值大小對肺部腫塊鑒別診斷有較高價(jià)值,肺良性和惡性病變組ADC值均隨b值增加而逐漸變小。
[Abstract]:Objective: to analyze the signal characteristics of diffusion-weighted imaging (diffusion-weighted) and the surface expansion coefficient (apparent diffusion) of lesions with different b values, and to evaluate the value of diffusion-weighted imaging (DWI) in lung tumor MRI. Methods: 37 cases of lung masses confirmed by CT and confirmed by pathology or clinical follow-up were collected. Routine MRI sequences and different b values (500,800,1000 s/mm2) DWI were performed. At the maximum diameter level of the lesion, the DWI signal intensity and the value of DWI were measured under each b value, and the value of the best b value and ADC value in the differential diagnosis of pulmonary masses were analyzed by (receiver operating characteristic curved-ROC. The relationship between DWI signal size and pathological type was analyzed. Results: (1) DWI of benign lung masses showed iso-low signal intensity or low signal intensity. 澶у鏁版伓鎬ц偪鍧桪WI鍛堢幇絳変俊鍙鋒垨楂樹俊鍙，

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