孤立性肺结节动态增强MRI的定量研究

Solitary pulmonary nodules:quantitative investigation with dynamic MRI

目的 探讨动态增强MRI对孤立性肺结节性质的鉴别诊断价值。方法 用动态增强MRI对 4 4例孤立性肺结节的增强模式进行定量分析。在动态增强时间 信号强度曲线基础上 ,测量病灶的最大增强线性斜率 (SS)、强化峰值 (PH) ,以及在增强后 1、2、4min时的信号强度改变率 (E1、E2及E4)。结果 恶性结节和炎症性结节较结核球有更高的SS[(4 4 4± 1 4 0 ) % /s、(3 99± 0 71) % /s、(0 86± 0 37) % /s,P <0 0 0 1]和PH(99 4 9± 2 0 5 2、10 8 2 0± 11 90、14 12± 5 92 ,P <0 0 0 1) ;炎症性结节在 4min时信号强度改变率E4高于恶性结节 [(12 0 0 2± 6 95 ) %与 (6 7 0 3± 18 0 4 ) % ,P <0 0 0 1]。结论 动态增强MRI能反映病灶的血供信息 。

Objective To evaluate the diagnostic efficacy of contrast enhanced dynamic MRI in differentiating benign from malignant solitary pulmonary nodules (SPNs) Methods A prospective study was undertaken in forty four patients with SPNs using contrast enhanced dynamic MRI Patterns of Time Signal Intensity Curve (T SI Curve) were assessed Steepest Slope (SS), Peak Height (PH) and the change rates in signal intensity at the first (E 1), second (E 2), and fourth (E 4) minute of T SI curve were calculated Results Malignant nodules and inflammatory nodules showed higher SS [(4 44±1 40) %/s,(3 99±0 71)%/s, (0 86± 0 37)%/s, P <0 001 ] values than that of the tuberculomas and bronchogenic cysts, respectively Inflammatory nodules showed higher E 4 values and later enhancement than what malignant nodules showed [(120 02± 6 95) % , (67 03±18 04)%, P <0 001] Conclusion Contrast enhanced dynamic MR imaging provides quantitative information of SPNs′ blood flow and is proved to be an applicable diagnostic methods for differentiating SPNs