DWI、DCE-MRI联合DKI在良恶性肺结节及病理亚型中的应用

Application of DWI,DCE-MRI and DKI in Benign and Malignant Pulmonary Nodules and Pathological Subtypes

目的探讨DWI、DCE-MRI联合DKI在良恶性肺结中的鉴别诊断及恶性肺结节病理亚型中的应用价值。方法选取本院47名SPN患者,男:30例,女:17例,年龄:29~86岁,平均年龄:58±5.62岁。行常规MR、DCE-MRI与DKI扫描。比较良恶性肺结节ADC、K^(trans)、K_(ep)、Ve、iAUC、Dapp与Kapp值及各参数在鳞癌、腺癌与良性肺结节中的差异性。结果(1)恶性肺结节的Ktrans、Ve、iAUC与Kapp值显著高于良性肺结节(P<0.035);(2)恶性肺结节ADC显著低于良性肺结节(P=0.001),其中腺癌的ADC值最低,Kapp值最高,对于K^(trans)、K_(ep)、Ve、iAUC、Dapp值鳞癌、腺癌与良性肺结节三组之间无明显差异。结论采用常规DWI、DCE-MRI联合DKI进行定量分析SPN,可提高MR在良恶性肺结节中鉴别诊断,且对恶性肺结节病理亚型鉴别诊断具有一定价值。

Objective To investigate the value of DWI,DCE-MRI and DKI in the differential diagnosis of benign and malignant pulmonary nodules and the pathological subtypes of malignant pulmonary nodules.Methods Forty seven patients with SPN in our hospital,male:30,female:17,age:29-86 years,mean age:58±5.62 years.Routine MR,DCE-MRI and DKI scans were performed.To compare the ADC,Ktrans,Kep,Ve,iAUC,app and app values of benign and malignant pulmonary nodules and the difference of each parameter in squamous cell carcinoma,adenocarcinoma and benign pulmonary nodules.Results(1)Ktrans,Ve、iAUC and Kapp of malignant pulmonary nodules were significantly higher than those of benign pulmonary nodules(P<0.035);(2)The ADC of malignant pulmonary nodules was significantly lower than that of benign pulmonary nodules(P=0.001),in which the ADC value of adenocarcinoma was the lowest and Kapp value was the highest.There was no significant difference between the Ktrans,Kep,Ve,iAUC,Dapp values of squamous cell carcinoma,adenocarcinoma and benign pulmonary nodules.Conclusion The quantitative analysis of SPN by conventional DWI,DCE-MRI and DKI can improve the differential diagnosis of benign and malignant pulmonary nodules by MR,and has certain value in the differential diagnosis of pathological subtypes of malignant pulmonary nodules.