磁共振弥散加权成像在良恶性肺实性结节中的诊断效能及相关参数分析

Diagnostic efficacy and related parameter analysis of diffusion-weighted magnetic resonance imaging in benign and malignant pulmonary solid nodules

目的:探讨磁共振弥散加权成像(DWI)在良恶性肺实性结节中的诊断效能及相关参数分析。方法:收集阳信县中医医院2021年9月—2023年9月磁共振检出肺内结节的55例患者(58个肺部病灶),对58个肺部病灶行穿刺活检并作为金标准,分析磁共振弥散加权成像在良恶性肺实性结节中的诊断效能及相关参数。结果:55例患者58个肺部病灶行穿刺活检检出恶性病变43个,良性病变15个。磁共振弥散加权成像诊断良恶性肺实性结节的灵敏度为92.50%、特异度为93.33%、准确率为92.73%,Kappa值=0.824,与金标准一致性较高。恶性肺实性结节患者表观弥散系数(ADC)值低于良性肺实性结节,病变与脊髓DWI信号强度之比(LSR)值高于良性肺实性结节,差异有统计学意义(P <0.05)。磁共振弥散加权成像参数ADC值、LSR值及两者联合诊断良恶性肺实性结节的受试者工作特征曲线下面积(AUC)分别为0.708、0.731、0.814,均有一定诊断价值。结论:磁共振弥散加权成像在良恶性肺实性结节中的诊断效能较高,ADC值、LSR值是其相关参数。

Objective To investigate the diagnostic efficacy and related parameters of diffusion-weighted magnetic resonance imaging in benign and malignant solid pulmonary nodules.Methods A total of 55 patients(58 lung lesions) with pulmonary nodules detected by MRI were collected from Yangxin County Hospital of Traditional Chinese Medicine from September 2021to September 2023.Puncture biopsy was performed on 58 lung lesions and used as the gold standard to analyze the diagnostic efficacy and related parameters of MRI diffusion weighted imaging(DWI) in benign and malignant solid pulmonary nodules.Results Among 58 lung lesions in 55 patients,43 malignant lesions and 15 benign lesions were detected by puncture biopsy.The sensitivity,specificity and accuracy of MRI in the diagnosis of benign and malignant solid pulmonary nodules were 92.50%,93.33% and 92.73%,with Kappa value =0.824,high consistency with gold standards.The apparent diffusion coefficient(ADC) of patients with malignant solid pulmonary nodules was lower than that of benign solid pulmonary nodules,and the lesion to spinal cord DWI signal intensity ratio(LSR) was higher than that of benign solid pulmonary nodules,with statistical significance(P < 0.05).The AUC values of ADC,LSR and their combination in the diagnosis of benign and malignant solid pulmonary nodules were 0.708,0.731 and 0.814,respectively,all of which had certain diagnostic value.Conclusion Magnetic resonance diffusion-weighted imaging has a higher diagnostic efficacy in benign and malignant pulmonary solid nodules,with ADC value and LSR value being its related parameters.