低场强磁共振在肺门区及纵隔肿块术前评估及定性诊断中的应用价值

Clinical value of low-field MR in diagnosis before operation of hilar zone and mediastinal mass

目的 :通过与螺旋CT检查对比 ,探讨低场强磁共振在肺门区及纵隔肿块诊断中的临床应用价值。方法 :将 6 5例病人随机分为两组 :实验组 32例 (其中 17例手术 ,肿块 2 1个 )用低场强磁共振机检查 ;对照组 33例 (其中 2 5例手术 ,肿块 31个 )行CT检查。结果 :对手术病例 ,按病灶与邻近的组织器官之间关系分为贴邻、粘连、包绕三种类型 ,MRI与CT对三种类型肿块 (个数 )检出的正确率分别为 10 0 % (10 / 10 )、6 1.5 % (8/ 13) ,P =0 .0 4 6 ;10 0 % (8/ 8)、5 0 % (6 / 12 ) ,P =0 .0 4 2 ;10 0 % (3/ 3)、6 6 .7% (4 / 6 ) ,P =0 .4 17。MRI与CT的术前评估正确率分别为 10 0 % (17/ 17)、6 4 % (16 / 2 5 ) ,P =0 .0 0 6。实验组与对照组定性诊断正确率分别为 96 .88% (31/ 32 )、81.82 % (2 7/ 33) ,经 χ2 检验P =0 .0 98。结论 :低场强磁共振在对肿块切除的术前评估方面优于CT 。

Objective: In contrast to spiral CT, effectiveness of low-field M R in clinical diagnosis of mass in hilar and mediastinal zone was probed. Methods:65 patients were classified into two groups, an experimental group and a cont rast group. The former including 32 patients (17 had undergone operation and 21 masses were found) underwent low-field MR. The latter including 33 patients ( 25 had undergone operation and 31 masses were found) underwent ordinary and enha nced CT scan.Results:For those having undergone operation, masses in them were classified into three types as neighboring, adhesive and wrapping according to c onfiguration of masses and their neighbor organs. MRI and CT's correctness ra tes in examination of neighboring-type mass were 100%(10/10) and 61.5%(8/13) re spectively (P=0.016, Fisher's exact test, the same the following), of adhesi ve were 100%(8/8) and 50%(6/12) respectively (P=0.042), of wrapping were 100 %(3/3) and 66.7%(4/6) respectively (P=0.417). Correctness rate of pre-opera tion assessment to invaded organs as big vessels or trachea and configuration of the masses and the organs were 100% (17/17) for MRI and 64%(16/25) for CT respe ctively (P=0.006). As for nature-determination correctness rate, the experi mental group and the control group were 96 88%(31/32) and 81.82%(27/33) respec ti vely, and the rate of ordinary scan of MRI was indifferent from that of the ordi nary scan complemented by enhanced scan of CT (P=0.098, χ 2 test). Conclusion: Low-field MR can raise correctness rate of pre-operation assessment rat e and success rate of operation, and ordinary scan of MRI can all-out replace t he ordinary and enhanced CT scan as well, helping patients free from radiologica l hurt and iodine allergy.