小视野IVIM-DWI在非小细胞肺癌与小细胞肺癌鉴别诊断中的应用

The application of zoomed IVIM-DWI in diagnosis of non-small cell lung cancer and small cell lung cancer

目的探讨基于并行传输技术的小视野体素内不相干运动扩散加权成像(ZOOMit IVIM-DWI)所得的定量参数在鉴别非小细胞肺癌(腺癌和鳞状细胞癌)与小细胞肺癌中的作用。方法选择术后病理诊断为小细胞肺癌14例,非小细胞肺癌38例(腺癌26例,鳞状细胞癌12例),共52例肺癌患者为观察对象,患者术前行ZOOMit IVIM-DWI检查,对所得到的肺癌的ZOOMit IVIM-DWI原始数据经双指数模型处理,得到对应的参数图,测量不同组肺癌的ADC平均值、D值、D*值、f值,并进行统计学分析,采用受试者工作特征曲线(ROC曲线)评估参数的诊断效能。结果非小细胞肺癌组的f值大于小细胞肺癌组,差异具有统计学意义(P<0.05);f值鉴别两者的曲线下面积(AUC)是0.779,诊断灵敏度为78.57%,特异度为78.95%。而ADC平均值、D值和D*值在两组之间差异均无统计学意义(P>0.05)。结论ZOOMit IVIM-DWI参数f值对鉴别非小细胞肺癌与小细胞肺癌具有一定作用,小细胞肺癌通常比非小细胞肺癌拥有更低的f值。

Objective To investigate the efficacy of the quantitative parameters obtained from the zoomed IVIM-DWI based on the parallel transmission technique(ZOOMit IVIM-DWI)in distinguishing non-small cell lung cancer(adenocarcinoma and squamous cell carcinoma)from small cell lung cancer.Methods 52 cases of lung cancer confirmed by postoperative pathology were selected as observation objects,including 38 cases of non-small cell lung cancer(26 cases of adenocarcinoma,12 cases of squamous cell carcinoma)and 14 cases of small cell lung cancer.Each patient was examined by ZOOMit IVIM-DWI before operation.The ZOOMit IVIM-DWI raw data of lung cancer obtained were processed by the double exponential model to get the corresponding parameter map.The ADCmean,D,D*,and f value of different groups of lung cancer were measured and performed statistical analysis on the results.Using the receiver operator characteristic curve(ROC),we evaluated the diagnostic efficacy of the parameters.Results The f value of the non-small cell lung cancer was greater than that of the small cell lung cancer,and the difference was statistically significant(P<0.05).The area under ROC(AUC)of f value for identifying two groups was 0.779.The diagnostic sensitivity was 78.57%and the specificity was 78.95%.ADCmean,D and D*value were not statistically different between two groups(P>0.05).Conclusion The f value of the ZOOMit IVIM-DWI has a certain effect on distinguishing non-small cell lung cancer from small cell lung cancer.Small cell lung cancer usually has a lower f value than non-small cell lung cancer.