肺癌和肺良性肿物的MRI诊断价值

目的:进一步探讨MRI技术在肺癌与肺良性肿物诊断中的价值。材料与方法:收集周围型肺癌30例(腺癌17例,鳞癌12例,腺鳞癌1例);肺良性肿物12例(结核球8例,错构瘤2例,炎性假瘤2例)。均行常规MRI扫描(GESigna1.5T),其中8例行静脉注射Gd-DTPA增强扫描。结果:周围型肺腺癌MRI信号表现为,T1WI呈略低或等信号,T2WI多呈高→略高信号(52.9%);鳞癌T1WI呈等信号,T2WI呈略高信号;冠状面图像可清晰显示肺上沟癌侵及胸膜顶情况,也可直观显示纵隔型肺癌的范围和侵及纵隔大血管情况;3例肺腺癌增强扫描呈完全强化模式;8例肺结核球T1WI呈略低或等信号,T2WI大多呈高、等、低不均匀混杂信号,卫星灶多见,3例增强者呈薄壁均匀环行强化;2例错构瘤及2例炎性假瘤均无特征性MRI表现。结论:MRI对周围型肺癌定性诊断价值有限,但对肺上沟癌和纵隔型肺癌范围的确定及定量诊断很有价值;结合增强扫描可对结核球做出正确诊断

MRI diagnostic value in pulmonary carcinoma and benign nodules

Objective:To study the MRI diagnostic value i n pulmonary carcinoma and pulmonary benign nodules.Mate-rial and Methods :Thi rty patients with peripheral pulmonary carcinoma(17cases with adenocarcinoma ,12squamous cell carci-noma and1adenosquamous carcinoma)and12patients w ith benign nodules(8cases with tuberculoma,2hamartoma and2in-flammatory p seudotumor)were examined with pre-contrast MRI(GE Signa1.5T),and8cases were examined with postcontrast MRI after injection of Gd-DTPA.Results:The peripheral pulmonary adenocarcinoma (n=17)showed mild hypo-or iso-in-te nsity on T 1 WI,and hyper-intensity to mild hyper-intensity on T 2 WI (52.9%);The squamous cell carcinoma (n=4)showed iso-intensit y on T 1 WI,and mild hyper-intensity on T 2 WI;Pulmonary sulcus tumor (n=3)infiltrating the apex pulmonis pleura an d the extent of mediastinal bronchogenic carcinoma (n=6)with infiltrating the great vessels were both showed clearly on coronary MR images;The marked en hancement of 3pulmonary carcinomas were seen on enhanced images;8cases with tu-berculoma showed mild hypo-intensity or iso-intensity on T 1 WI,and mixed hyper-,iso-and hypo-intensity were seen on T 2 WI,and the thin-ring enhancement was seen on all3enhanced tuberculoma;N o specific MRI findings were found on2cases of hamartoma and2cases of inf lammatory pseudotumor.Conclusion:The MRI diagnostic value on peripheral pul- monary carcinoma was not effective,but more useful for showing the extent and diagnosis quantitatively of pulmonary sulcus tumor and mediastinal bronch ogenic carcinoma;The pre-and post-contrast MRI scanning were very effective for distinguish a tuberculoma from pulmonary carcinoma .