Gd-DTPA增强MRI诊断肺内结节

Diagnosis of pulmonary nodule by Gd-DTPA enhanced MRI

目的：研究Gd－DTPA增强MRI在孤立性肺结节鉴别诊断中的作用。材料和方法：对26例≤3cm的孤立肺内结节（肺癌16例，结核10例）进行了常规和动态Gd－DTPA增强MRI检查，测量病灶的增强程度，分析MRI表现并与病理对照。结果：16例肺癌在静脉注入Gd－DTPA后均有强化，表现为实体均匀（9例）和不均匀（7例）增强，而多数（8／10）结核球表现为环形增强。肺癌平均增强71％，与结核球（23％）有显著差异。肺癌结节的动态增强曲线也与结核球不同。结论：肺癌与结核球的MRI增强形态和增强程度不同，对鉴别诊断很有帮助。

Purpose:To evaluate the role of Gd-DTPA enhanced MRI in the differential diagnosis of solitary pulmonary nodules. Materials and methods: 26 patients with solitary pulmonary nodules (16 lung cancers, 10 tuberculomas) 3cm or smaller in diameter were examined bymeans of conventional and dynamic Gd-DTPA enhanced MRI. The enhancement degree as wellas enhancement patterns were analyzed and compared with pathologic findings. Results:All of the16 lung cancer nodules showed a homogeneous (n = 9 )or inhomogeneous (n = 7) enhancement afterbolus injection of paramagnetic contrast agent while majority of tuberculomas (8/10) manifestring-like enhancement. The average enhancement rate for the malignant nodules (71 % )is higherthan that of tuberculomas (23 % ) (P<0. 01 ), The dynamic enhancement curves also showed difference between lung cancer and tuberculoma. Conclusion:The enhancement patterns and degrees oflung cancer differ from that of tuberculoma,thus beneficial for differential diagnosis.