胸部MR-DWI成像对指导肺部病变穿刺价值的分析

目的探讨DWI在肺部病变穿刺活检中的应用价值。方法搜集的病例均应用DWI和CT扫描,在DWI和ADC图上测量实性区、内部的坏死区以及病变周围的肺不张、阻塞性肺炎区域的信号强度和ADC值,均数比较采用t检验;CT和MR鉴别肿瘤与不张、坏死能力的比较应用χ2检验;P<0.05为差异有统计学意义。结果肺癌与良性病变实性区信号强度和ADC均值差异有统计学意义(t=8.236和5.679,P<0.05)。肺癌中坏死区与实性区平均ADC值比较有统计学意义(t=14.40,P<0.05);22例中心型肺癌实性区和肺不张、阻塞性肺炎区平均ADC值比较有统计学意义(t=34.76,P<0.05)。MR显示病变内坏死和区分肿瘤与肺不张优于CT(P<0.05)。结论 DWI成像判断肿瘤内坏死和周围肺不张、阻塞性肺炎准确,帮助确定穿刺活检靶点,提高活检成功率。

Objective To explore the value of DWI in the biopsy of lung lesions. Methods The cases were scanned by DWI,signal intensity and ADC value were measured and compared with t test,comparison of CT and MR was analyzed by χ 2 . Results Differences between lung cancer and benign solid areas of signal intensity and ADC value were found（t =8.236 and 5.679,P 〈0.05）. The average ADC of lung cancer in the necrotic and solid area were statistically significant（t = 14.40,P 〈0.05）,the same as the comparison between lung cancer solid and atelectasis,obstructive pneumonia（t =34.76,P 〈0.05）. MR is better than CT（P 〈0.05）. Conclusion DWI imaging is accurate in differentiating tumor necrosis and obstructive pneumonia.