肺癌与结核球的MRI增强研究

Gd DTPA enhanced MRI in bronchogenic carcinoma and tuberculoma

目的：研究肺癌增强ＭＲＩ的表现和病理基础，探讨增强ＭＲＩ在肺癌诊断中的作用。材料与方法：对１９例原发周围型支气管肺癌，１０例结核球行常规和动态增强ＭＲＩ检查，分析其表现并与病理对照。测量病灶实体的增强程度，绘出动态时间－信号强度曲线。结果：所有肺癌在静脉注入Ｇｄ－ＤＴ－ＰＡ后均有强化，表现为三种形式：均匀型、不均匀型和厚壁空洞型；结核球多数表现为薄壁环形增强；各种增强形式有不同的病理基础。肺癌组平均增强７１％，明显高于结核球组（４１％，Ｐ＜０．０１）；肺癌的动态增强时间－信号强度曲线也与结核球不同，结论：肺癌的增强形式和增强程度与结核球不同。

Purpose: To evaluate enhancement characteristics of MRI and the pathologic basis for diagnosis and differential diagnosis of peripheral bronchogenic carcinoma. Materials and methods: Conventional and dynamic Gd DTPA enhanced MRI of peripheral bronchogenic carcinoma (19 cases) and tuberculoma (10 cases) were analyzed and compared with the pathologic findings. The relative signal intensity of lesions was calculated and plotted as time intensity curves. Results: All bronchogenic carcinoma yielded enhanced images after intravenous Gd DTPA presenting 3 patterns: homogeneous type, uneuenly mottled type and thick wall cavity type. Tuberculoma, however, generally manifested as slim ring like enhancement and various enhancement patterns based on different pathologic basis. The average degree of enhancement of bronchogenic carcinoma was 71% significantly different from that of tuberculoma (41%, P <0.01). The time intensity curve of tumor was also different as compared with that of most tuberculomas. Conclusion: The enhanced patterns of bronchogenic carcinoma while different from those of tuberculoma were helpful in differential diognosis.