IVIM-DWI慢速表观扩散系数对不同病理类型肺癌的鉴别诊断价值

Value of slow apparent diffusion coefficient of IVIM-DWI in differential diagnosis of lung cancer with different pathological types

目的探讨体素内不相干运动扩散加权成像(IVIM-DWI)慢速表观扩散系数(ADC)对不同病理类型肺癌的鉴别诊断价值。方法抽取2018年3月至2020年3月信阳职业技术学院附属医院收治的93例肺癌患者为研究对象,全部患者均接受IVIM-DWI和病理检查,根据病理检查结果对患者进行病理分型。比较不同病理类型肺癌患者IVIM-DWI参数[ADC、慢速表观扩散系数(D)、快速表观扩散系数(D*)],分析IVIM-DWI参数对肺癌病理类型的鉴别诊断价值。结果经穿刺活检病理检查结果显示,小细胞肺癌(SCLC)18例,非小细胞肺癌(NSCLC)75例(鳞癌24例,腺癌51例)。SCLC患者ADC、D、D*值低于NSCLC患者(P<0.05);腺癌、鳞癌患者ADC、D、D*值比较差异未见统计学意义(P>0.05)。绘制受试者工作特征曲线发现,IVIM-DWI参数ADC、D、D*值鉴别SCLC不同病理类型的曲线下面积分别为0.673、0.848、0.679,D值鉴别价值高于ADC、D*值。结论不同病理类型肺癌IVIM-DWI参数存在差异,其中D值鉴别SCLC的价值较高。

Objective To investigate the value of slow apparent diffusion coefficient(ADC)of intraintravoxel incoherent motion-diffusion weighted imaging(IVIM-DWI)in the differential diagnosis of lung cancer with different pathological types.Methods A total of 93 patients with lung cancer treated in the Affiliated Hospital of Xinyang Vocational and Technical College from March 2018 to March 2020 were selected as research objects.All patients received IVIM-DWI and pathological examination.According to the results of pathological examination,the patients underwent pathological classification.IVIM-DWI parameters,including ADC,slow apparent diffusion coefficient(D),fast apparent diffusion coefficient(D*)of lung cancer patients with different pathological types were compared.And the value of IVIM-DWI parameters in differentiating pathological types of lung cancer were analyzed.Results Results of pathological examination of puncture biopsy showed 18 cases of small cell lung cancer(SCLC),75 cases of non-small cell lung cancer(NSCLC),including 24 cases of squamous cell carcinoma and 51 cases of adenocarcinoma.The ADC,D and D*values of SCLC patients were lower than those of NSCLC patients(P<0.05);but there was no significant difference in the comparison of ADC,D and D*between patients with adenocarcinoma and patients with squamous cell carcinoma(P>0.05).The receiver operating characteristic curve found that the area under the curve values of ADC,D and D*of IVIM-DWI parameters in differentiating different pathological types were 0.673,0.848 and 0.679,respectively;differential diagnose value of D was higher than those of ADC and D*.Conclusions The IVIM-DWI parameters of different pathological types of lung cancer are different,of which the value of D is higher in differentiating SCLC.