3.0T MRI常规平扫、DWI及IVIM扫描在良恶性肺结节鉴别中的应用价值

Application value of 3.0T MRI conventional plain scan,DWI and IVIM scans in the differentiation of benign and malignant pulmonary nodules

目的探讨3.0T MRI常规平扫、DWI及IVIM扫描在良恶性肺结节鉴别中的应用价值。方法选取收治的73例肺结节患者作为研究对象,均采用3.0T MRI常规平扫、DWI及IVIM扫描。比较各种扫描方法的诊断效能、不同B值(300、500、800 s/mm2)时良恶性肺结节的信号强度ADC值、以肌肉、胸髓为参照良恶性肺结节的DWI信号强度评分,并计算IVIM扫描诊断良恶性肺结节的ADCmean、ADCmin、D及f值。结果IVIM扫描的灵敏度、特异度、阳性预测值、阴性预测值及准确度均高于常规MRI平扫及DWI扫描,且DWI扫描高于常规MRI平扫。当B值为500 s/mm2时,良性肺结节的ADC值大于恶性肺结节(P<0.05)。以肌肉、胸髓为参照,恶性肺结节的DWI信号强度评分均高于良性肺结节(P<0.05)。IVIM扫描中,恶性肺结节的ADCmean、ADCmin、D及f值均低于良性肺结节(P<0.05)。结论IVIM扫描在良恶性肺结节诊断中的应用价值更高,更利于早期判断,具有较高的灵敏度。

Objective To explore the application value of 3.0T MRI conventional plain scan,DWI and IVIM scans in the differentiation of benign and malignant pulmonary nodules.Methods A total of 73 patients with pulmonary nodules were selected as the study objects.All patients were performed with 3.0T MRI conventional plain scan,DWI and IVIM scans.The diagnostic efficiency of each scan methods,the ADC value of the signal intensity of benign and malignant lpulmonary nodules at the different B value(300,500,800 s/mm2),the DWI signal intensity score of benign and malignant pulmonary nodules with muscle and thoracic pulp as reference were compared.ADCmean,ADCmin,D and f values of benign and malignant pulmonary nodules in IVIM scan were calculated.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy in IVIM scan were higher than those in conventional MRI scan and DWI scan,and those in DWI scan were higher than conventional MRI scan.When the B value was 500 s/mm2,the ADC value of benign pulmonary nodules was greater than that of malignant pulmonary nodules(P<0.05).The DWI signal intensity score of malignant pulmonary nodules with muscle and thoracic pulp as reference were higher than those of the benign pulmonary nodules(P<0.05).ADCmean,ADCmin,D and f values of malignant pulmonary nodules in IVIM scan were lower than those in benign pulmonary nodules(P<0.05).Conclusion IVIM scan has higher application value in the diagnosis of benign and malignant pulmonary nodules,which is more conducive to early judgment and has higher sensitivity.