对比增强磁敏感加权成像对肺癌脑转移瘤检出的研究

目的:探索对比增强磁敏感加权成像(CE-SWI)在肺癌脑转移瘤检出中的价值。方法:肺癌脑转移病例50例,分析增强T₁WI(CE-T₁WI)、SWI与CE-SWI对脑转移瘤的检出个数,采用χ²检验分析三种序列之间的差异,评估CE-SWI在肺癌脑转移瘤检出的敏感性。结果:CE-T₁WI、SWI与CE-SWI共检出病灶142个,其中CE-T₁WI检出率81%,CE-SWI检出率88%,SWI检出率77%,χ²检验三者有显著统计学差异(P<0.05)。分层分析最大直径<3 mm的病灶共检出36个,其中CE-T₁WI检出率58%,CE-SWI检出率83%,SWI检出率72%,χ²检验三者有明显统计学差异(P<0.05)。结论:对于<3 mm的微小转移病灶的检出,CE-SWI比CE-T₁WI更有优势;对有明显出血的转移灶,CE-SWI也能清晰显示肿瘤的强化区;CE-SWI是脑转移瘤MRI检查常规序列的有效补充。

A study of contrast-enhanced susceptibility weighted imaging in the detection of brain metastases from lung cancer

Objective:To explore the diagnostic value of contrast-enhanced susceptibility weighted imaging(CE-SWI)in the detection of brain metastases from lung cancer.Methods:Fifty cases of brain metastases from lung cancer were enrolled,and the number of brain metastases was detected by CE-T₁WI,SWI and CE-SWI.Chi square test was used to analyze the difference among the three sequences and evaluate the sensitivity of CE-SWI in the detection of lung cancer brain metastases.Results:A total of 142 lesions were detected by CE-T₁WI,SWI and CE-SWI,of which the detection rate of CE-T₁WI was81%,that of CE-SWI was 88%and that of SWI was 77%.There was significant difference among the three groups by chi square test(P<0.05).A total of 36 lesions with a maximum diameter of smaller than 3 mm were detected by stratified analysis,of which the detection rate of CE-T₁WI was 58%,CE-SWI was 83%,and SWI was 72%.There was significant difference among them by chi square test(P<0.05).Conclusion:CE-SWI is superior to CE-T₁WI on detecting brain metastases which are smaller than 3 mm.CE-SWI can clearly show the enhanced areas of tumor for metastasis with obvious bleeding.CE-SWI is an additional useful tool for routine MRI sequences on brain metastases screening.