磁共弥散加权成像与动态增强扫描在肺癌临床分期中联合诊断价值分析

目的探讨磁共振弥散加权成像(DWI)及磁共振动态增强扫描(DCE-MRI)在肺癌患者临床分期诊断中的联合应用价值。方法选取我院肺癌患者137例(2016年12月~2018年12月),所有患者均接受DWI及DCE-MRI检查,统计分析不同临床分期肺癌患者ADC值、细胞外血管外空间体积分数(Ve)、速率常数(Kep)、转运常数(Ktrans)和ADC值、Ve、Kep及Ktrans与疾病分期间关联性,并统计分析DWI联合DCE-MRI对肺癌不同临床分期诊断情况。结果 (1)ADC值:单因素方差检验可知,不同临床分期肺癌患者ADC值间存在显著差异(P<0.05),多重比较,Ⅲ期患者ADC值低于Ⅰ~Ⅱ期者(P<0.05),Ⅳ期患者ADC值低于Ⅲ期患者(P<0.05);(2)Ve、Kep及Ktrans:单因素方差检验可知,不同临床分期肺癌患者Ktrans间存在显著差异(P<0.05),Ve、Kep间未见显著差异(P>0.05),多重比较,Ⅲ期患者Ktrans高于Ⅰ~Ⅱ期者(P<0.05),Ⅳ期患者Ktrans高于Ⅲ期患者(P<0.05);(3)关联性分析:经Pearson检验可知,ADC值(r=-0.691)与肺癌分期间存在明显负相关关系、Ktrans(r=0.802)与肺癌分期间存在明显正相关关系(P<0.05);(4)临床分期诊断情况:DWI联合DCE-MRI对肺癌临床分期诊断准确率可达90.51%(124/137),一致性检验Kappa值为0.865(P<0.05)。结论肺癌患者经DWI及DCE-MRI检查可见明显异常,随临床分期增高ADC值呈降低趋势、Ktrans呈增高趋势,联合两种措施进行综合诊断,可显著提高疾病临床分期诊断准确性,为临床早期制定、调整有针对性治疗方案提供客观参考依据。

Analysis of Combined Diagnostic Value of Magnetic Diffusion-weighted Imaging and Dynamic Enhanced Scanning in Clinical Staging of Lung Cancer

Objective To investigate the combined value of magnetic diffusion-weighted imaging(DWI) and magnetic resonance dynamic contrast-enhanced scanning(DCEMRI) in the clinical staging of lung cancer patients. Methods A total of 137 patients with lung cancer in our hospital(December 2016-December 2018) were enrolled. All patients underwent DWI and DCE-MRI. The ADC values and extracellular extravascular space volume fraction of patients with different clinical stages of lung cancer, rate of constant(Kep), transport constant(Ktrans) and ADC value, Ve, Kep and Ktrans are associated with disease stage, and statistical analysis of DWI combined with DCE-MRI for different clinical stages of lung cancer diagnosis were statistically analyzed. Results(1) ADC value: Oneway variance test showed that there were significant differences in ADC values between different clinical stages of lung cancer patients(P<0.05). Multiple comparisons, ADC values of stage Ⅲ patients were lower than those of stage Ⅰ~Ⅱ(P<0.05). The ADC value of patients with stage IV was lower than that of stage Ⅲ patients(P<0.05).(2) Ve, Kep and Ktrans: One-way ANOVA showed that there were significant differences between Ktrans in different clinical stages of lung cancer patients(P<0.05). There was no significant difference between Kep(P>0.05). Multiple comparisons showed that patients with stage Ⅲ Ktrans were higher than patients with stage Ⅰ~Ⅱ(P<0.05), and patients with stage IV were higher than patients with stage Ⅲ(P<0.05).(3) Correlation analysis: According to Pearson test, there was a significant negative correlation between ADC value(r=-0.691) and lung cancer, and Ktrans(r=0.802) was significantly positively correlated with lung cancer(P<0.05). Clinical staging diagnosis: DWI combined with DCE-MRI can accurately diagnose the clinical stage of lung cancer by 90.51%(124/137), and the consistency test Kappa value is 0.865(P<0.05). Conclusion DWI and DCE-MRI examination showed obvious abnormalities in the lung cancer patients. The ADC value decreased and the Ktrans increased with the clinical stage. Combined with the two measures for comprehensive diagnosis, the clinical diagnosis of the disease can be significantly improved. Provide an objective reference for the development and adjustment of targeted treatment programs.