摘要
目的 探讨动态对比增强 ( DCE ) - 磁共振成像 ( MRI )在肺部良恶性病变鉴别诊断中的应用价值。方法 收集经病理证实的肺占位性病变患者 32 例,其中恶性 19 例,良性 13 例,均行DCE-MRI 检查。测量 MRI 定量参数,包括:容积转运常数 ( K^trans )、回流速率常数 (Kep)、血管外细胞外容积分数 ( V e )和血管内血浆容积 ( Vp )。采用独立样本 t 检验比较良恶性病变各测量参数值间的差异。绘制 ROC 曲线评估定量 DCE-MRI 鉴别肺部良恶性病变的诊断效能。结果 恶性病变参数K^trans 、 Kep、 V e 和 V p 值分别为 ( 0.632±0.418 ) min^-1、 ( 1.324±0.514 ) min^-1、 0.431±0.207 和0.193±0.103 ,良 性 病 变 K^trans 、 Kep、 V e 和 V p 值 分 别 为 ( 0.107±0.091 ) min^-1、 ( 0.667±0.259 ) min^-1、 0.357±0.125 和 0.096±0.042 ,恶性病变与良性病变间 K^trans 、 Kep差异有统计学意义( t 值分别为 4.112 、 3.625 , P 值均 〈0.05 ),恶性病变与良性病变间 V e 、 V p 差异无统计学意义 ( t 值分别为 1.284 、 2.248 , P 值均 〉0.05 )。 K^trans 、 Kep这 2 个参数 ROC 曲线下面积分别为 0.882 、 0.846 ,判断肺良恶性病变的敏感度分别为 92.3% 、 91.7% ,特异度分别为 87.5% 、 75.0% 。结论 DCE-MRI可定量评估肺部病变毛细血管的通透性,参数 K^trans 、 Kep值在肺良恶性病变的鉴别诊断中具有重要临床价值。
Objective To investigate the application value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differential diagnosis of benign and malignant lung lesions. Methods 32 patients with lung lesions (19 cases of malignant lesions and 13 cases of benign lesions) proven by pathological results underwent DCE MRI. The quantitative MRI pharmaeokinetic parameters including K^trans,Kep, Ve and Vp were measured. These parameters o5 the two groups were statistically compared using Student's t test. Receiver operating characteristic (ROC) curve was used to compare the diagnostic capability of DCE-MRI. Results K^trans, Kep, Ve and Vp of malignant lesions were (0. 632±0. 418) min^-1, ( 1. 324± 0. 514) min^-1 , 0. 431 ± 0. 207 and 0. 193± 0. 103,K^trans , Kop, Ve and Vp of benign lesions were (0. 107±0. 091) mini , (0. 667±0. 259) min^-1 ,0.357±0. 125 and 0. 096±0. 042, respectively. There were significant differences between malignant lesions and benign lesions in K^trans and Kep ( t = 4. 112, 3. 625, respectively, all P 〈 0.05). There was no significant difference between malignant lesions and benign lesions in Ve and Vp (t = 1. 284, 2. 248, respectively, all P 〉0.05). The areas under the ROC curve of K^trans and Kep in malignant lesions and benign lesions were 0. 882,0. 846 respectively, the sensitivity were 92.3%, 91.7 % and specificity were 87.5 %, 75.0% for the differential diagnosis of pulmonary lesions.Conclusions DCE-MRI can quantitatively evaluate the microvascular permeability, the quantitative parameters K , Kep are capable of the differential diagnosis between benign and malignant lung lesions which has an important value in clinical work.
出处
《国际呼吸杂志》
2017年第2期96-101,共6页
International Journal of Respiration
关键词
肺癌
磁共振成像
动态增强
Lung neoplasms
Magnetic resonance imaging
Dynamic contrast-enhanced