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MRI 扩散加权成像评价孤立性肺结节的价值
引用本文:任进军,赵宝宏,于哲,张玉环,訾学荣,徐倩,陈艳芳. MRI 扩散加权成像评价孤立性肺结节的价值[J]. 临床荟萃, 2014, 29(11): 1265-1267
作者姓名:任进军  赵宝宏  于哲  张玉环  訾学荣  徐倩  陈艳芳
作者单位:华北石油总医院 医学影像科%华北石油总医院 心胸外科,河北 任丘,062552
摘    要:目的:探讨 MRI 扩散加权成像(diffusion weighted imaging,DWI)对良、恶性孤立性肺结节(solitary pulmonary nodule,SPN)鉴别诊断价值,以及优化最佳 b 值选择。方法收集2012年1月至2014年5月 CT 检查发现 SPN 患者82例,并经手术、针刺活检、综合影像或临床治疗随访后证实,其中恶性患者45例,良性患者37例,全部行 MRI 胸部常规 T1 WI、T2 WI 和 DWI 检查,b 值选择300,500,800和1000 s/mm2。以 SPN 在 T1 WI 最大直径15 mm 为标准分为两组,分别测量在不同 b 值情况下的 ADC 值。结果良、恶性 SPN 的 ADC 值均随 b 值增加而逐渐变小,最大直径小于15 mm 组中,良、恶性 SPN 在 b 值=500 s/mm2时,其 ADC 值差异有统计学意义(t =2.35,P <0.05);最大直径大于15 mm 组中,良、恶性 SPN 在 b 值为800~1000 s/mm2时,其 ADC 值差异有统计学意义(t =2.30,P <0.05;t =4.08,P <0.01)。结论 SPN 大小是 DWI 的 b 值选择影响因素,DWI 鉴别诊断 SPN 具有重要临床应用价值。

关 键 词:肾功能不全  造影剂  体层摄影术  

Evaluation of solitary pulmonary nodule by diffusion-weighted MR imaging
REN Jin-jun,ZHAO Bao-hong,YU Zhe,ZHANG Yu-huan,ZI Xue-rong,XU Qian,CHEN Yan-fang. Evaluation of solitary pulmonary nodule by diffusion-weighted MR imaging[J]. Clinical Focus, 2014, 29(11): 1265-1267
Authors:REN Jin-jun  ZHAO Bao-hong  YU Zhe  ZHANG Yu-huan  ZI Xue-rong  XU Qian  CHEN Yan-fang
Affiliation:REN Jin-jun, ZHAO Bao-hong, YU Zhe, ZHANG Yu-huan, ZI Xue-rong, XU Qian, CHEN Yan-fang ( a. Department of Medical Imaging ; b. Department of Cardiothoracic Surgery, the General Hospital of North China Petroleum Administration Bureau, Renqiu 062552, China)
Abstract:Objective To evaluate the values of diffusion weighted imaging(DWI)in the differential diagnosis of benign and malignant solitary pulmonary nodule(SPN)by magnetic resonance imaging(MRI)and to optimize the b values for MRI.Methods Eighty-two SPN patients diagnosed by CT examination from January 2012 to May 2014 were enrolled in this study.All patients were confirmed by surgery,needle biopsy,combined imaging and clinical follow-up,among which there were 45 cases of malignant SPN and 37 cases of benign lesions.All patients underwent T1 weighted imaging(T1 WI),T2 weighted imaging (T2 WI)and DWI examination with b values of 300,500,800 and 1 000 s/mm2 .The lesions were divided into two groups by a cut-off diameter of 1 5 mm under T1 WI,and then the apparent diffusion coefficient(ADC)values of the lesions under DWI with different b values were measured.Results The ADC values of benign and malignant SPNs were gradually reduced with the increase of b values.Among the lesions with maximum diameter less than 1 5 mm,the ADC values of benign and malignant SPNs showed statistically significant difference at b value of 500 s/mm2 (t = 2.35,P 〈 0.05 ).However,among the lesions with maximum diameter larger than 1 5 mm,the ADC values of benign and malignant SPNs were significantly different at b value of 800 to 1 000 s/mm2 (t =2.30,P 〈0.05 and t =4.08,P 〈0.01 ).Conclusion The size of SPNs is an influencing factor for the choice of b values and DWI has important clinical application value in the differential diagnosis of SPNs.
Keywords:solitary pulmonary nodule  magnetic resonance imaging  Diffusion weighted imaging
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