磁共振动态增强扫描及波谱成像对肺内结节性病变的鉴别诊断研究

目的观察肺内结节性病变磁共振(MRI)动态成像及磁共振波谱成像(MRS)特征,探讨其鉴别诊断价值。方法选择105例肺内结节性病变患者为研究对象,均接受MRI平扫、动态增强扫描及MRS成像。观察肺内结节性病变MR平扫特征及动态增强扫描信号强度改变情况及MRS参数的差异。结果肺癌、肺炎性假瘤及肺结核球T1WI平扫信号强度间差异无统计学意义(P0.05),三者平均增强峰值、强化增值及S/A比值间比较,差异均具有统计学意义(P0.05)。其中炎性假瘤增强峰值及强化增值最高,S/A比值最大,肺结核球最低。肺癌Cho、Lac135、Lac270及Cho/Cr均显著高于肺炎性假瘤及肺结核球,NAA显著低于后两者,差异均具有统计学意义(P0.05)。肺炎性假瘤及肺结核球间比较,Cho、Cr、NAA、Lac135、Lac270及Cho/Cr比较,差异无统计学意义(P0.05)。结论肺癌与肺炎性假瘤、肺结核球动态增强特征、MRS代谢物含量不同,MRI增强扫描及MRS对其有鉴别诊断价值。

Differential Diagnosis of Pulmonary Nodules by Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy

Objective To observe the magnetic resonance imaging(MRI) and magnetic resonance spectroscopy(MRS) characteristics of pulmonary nodules, and to investigate the value in differential diagnosis.Methods A total of 105 patients with pulmonary nodules were selected as the study objects, and all the objects underwent MRI plain scan, dynamic enhanced scan and MRS imaging to observe the plain scan characteristic, the changes of signal on dynamic enhanced scan and the parameter difference of MRS.Results There was no significant difference in the intensity of T1WI (P>0.05) in patients with pulmonary cancer, pulmonary inflammatory pseudotumor and pulmonary tuberculosis. The comparison between the average peak value of them and the increased value after enhancement and the S/A ratio showed that the difference was statistically significant (P<0.05). The peak value, the increased value after enhancement and the S/A ratio of the pulmonary inflammatory pseudotumor hit the highest value, and the pulmonary tuberculosis had the lowest value. The value of Cho, Lac135, Lac270 and Cho/Cr of pulmonary cancer were significantly higher than those of the pulmonary inflammatory pseudotumor and pulmonary tuberculosis, and the value of NAA was significantly lower than pulmonary inflammatory pseudotumor and pulmonary tuberculosis, the difference was statistically significant (P<0.05). The comparison of Cho、Cr、NAA、Lac135、Lac270 and Cho/Cr between the pulmonary inflammatory pseudotumor and pulmonary tuberculosis had no statistically significant (P>0.05).Conclusion The dynamic enhancement characteristics and MRS metabolites of pulmonary cancer was different from pulmonary tuberculosis and pulmonary inflammatory pseudotumor. The MRI dynamic enhancement scan and MRS imaging had differential diagnostic value in the diagnosis.