肺孤立性病变的ADC直方图的比较研究

Diffusion-weighted MR imaging of solid solitary pulmonary lesions:a comparison of ADC histogram

目的探讨基于单个最大层面(2D)及体积(3D)感兴趣区(ROI)的ADC直方图参数在区分肺良性及恶性孤立性实性病灶的价值。方法本回顾性研究共纳入69例肺部孤立性实性病变患者,其中恶性56例,良性13例。所有患者术前均采用MRI、DWI(b=600 mm/s^(2))检查,使用OK软件获取病灶最大截面面积(2D)及体积(3D)ADC直方图特征参数值。运用ROC曲线比较两种测量方法的鉴别效能。结果2D、3D直方图大部分参数在肺良恶性病变组间差异具有统计学意义(P<0.05),其中以ADC 50分位数(50^(th))、75分位数(75^(th))、90分位数(90^(th))为著(P<0.001)。2D直方图中的ADC 75^(th)及3D直方图中的ADC 50^(th)有较好诊断效能(AUC分别为0.891、0.894)。当3D ADC 50^(th)取1.41×10^(-3)mm^(2)/s时,诊断的准确性最高,敏感度为80.00%,特异度为92.86%。ADC最大值(maximum)、ADC 25分位数(25^(th))及峰度组间差异无统计学意义(P>0.05)。结论2D及3D ADC直方图在肺部病变鉴别有一定价值,其中以3D直方图的ADC 50^(th)最佳。

Objective To investigate the value of ADC histogram parameters measured by 2D and 3D ROI in distinguishing benign and malignant solitary solid pulmonary lesions(SPL).Methods A total of 69 patients with SPL were included in this retrospective study,including 56 patients with malignant disease and 13 patients with benign disease.All patients underwent preoperative MRI and DWI(b=600 mm/s^(2))examinations.The ADC histogram parameters of the lesion from 2D and 3D ROI were obtained by OK software.ROC curve was used to compare the discriminative efficacy of these two methods.Results Most parameters of 2D and 3D histogram showed a statistically significant difference between benign and malignant pulmonary lesions(P<0.05),especially ADC 50 quantiles(50^(th)),75 quantiles(75^(th))and 90 quantiles(90 th)(P<0.001).The ADC 75^(th)in 2D histogram and ADC 50^(th)in 3D histogram had better diagnostic efficiency(AUC were 0.891 and 0.894,respectively).When the ADC 50^(th)of 3D histogram was 1.41×10^(-3)mm^(2)/s,the accuracy of diagnosis was the highest,with a sensitivity of 80.00%and a specificity of 92.86%.There were no significant differences in ADC maximum,25 th and kurtosis among groups(P>0.05).Conclusion Both 2D and 3D ADC histograms had a certain value in the diagnosis of SPL,and ADC 50^(th)of 3D histogram showed the best efficacy.