肺癌及肺结核MR背景抑制扩散加权成像与病理类型关系的探讨

Discusse about Relationships of Lung Cancer and Tuberculosis MR Background Inhibit Diffusion Weighted Imaging and Pathological Types

目的 探讨肺癌及肺结核MR背景抑制扩散加权成像（DWIBS）表现特征与病理类型之间的关系.方法 对42 例经病理证实且行DWIBS扫描的肺癌病例及10例经病理证实且行DWIBS扫描的肺结核病例进行回顾性分析,测量病灶的表现扩散系数（ADC）,将其与病变的病理类型进行对照分析.结果 鳞癌、腺癌、小细胞癌及肺泡癌的ADC值分别为（1.82±0.15）×10^-3mm^2/s,（1.17±0.32）×10^-3mm^2/s,（2.24±0.65）×10^-3/smm^2/s,（0.93±0.08）×l0-3mm^2/s,肺结核的ADC值为（0 46±0.36）×10^-3mm^2/s,小细胞癌的ADC值明显高于其他类型,鳞癌的ADC值与腺癌、小细胞癌、肺泡癌的ADC值均有明显差异（P＜0.05）,小细胞癌与腺癌、肺泡癌的ADC值有明显差异（P＜0.01）,腺癌与肺泡癌的ADC值差异无统计学意义（P＞0.05）,肺结核的的ADC值明显低于肺癌（P＜0.01）.结论 肺癌及肺结核的ADC值与其病理类型有一定的相关性,可以对肺癌及肺结核的诊断、鉴别诊断和治疗提供一定的依据.

Objective To study the correlation of MR diffusion weighted imaging with background body signal suppression（ MRDWIBS） features and different palhologieal types in hung earcinoma and pulmonary tuberculosis. Methods Forty-two cases of lung carcinoma and ten cases of pulmonary tuberculosis proved pathologically and examined with MR-DWIBS were analyzed retrospectively in this study. The ADC of each lung cancer patients was calculated,and were compared with the dii＇ferent pathological types. Results The ADC of hmg cancer were（ 1.82 ±0. 15 ） × 10 ^-3mm^2/s for squamous carcinoma, （ 1.17 ±0.32） ×10^-3mm^2/s for adenocareinoma, （2.24 _＋0.65 ） x 10 -3 mm^-3/s for snmll eell carcinoma and（0.93 ± 0.08） × 10 ^-^3mm^2/s for alveolar cell carcinoma. The ADC of puhnonary tuberculosis were（0.46 ± 0. 36） 0.36×10^- 3mm^2/s. The ADC in small cell carcinoma was significantly higher than other pathological types. There were highly differenees of ADC between squamous carcinoma and other pathological types. And there were highly dififferences of ADC between small cell careinonm and adenocarcinoma and alveolar cell carcinoma. No significance was found among adenoearciuoma and alveolar cell carcinoma. The ADC of pulmonary tuberculosis was significantly lower than all lung cancer pathological types. Conclusion The ADC of hung carcinoma and puhnonary tuberculosis rell eeles the pathological type in some extent,and has important c.linieal value in diagnosis and treatment of lung carcinoma.