常规MRI联合DCE-MRI在结节或肿块型肺结核中的诊断价值

Diagnostic Value of Conventional MRI Combined with DCE-MRI in Nodular or Mass Pulmonary Tuberculosis

目的:探讨常规MRI联合动态增强MRI(DCE-MRI)在结节或肿块型肺结核中的诊断价值。方法:收集16例经穿刺或临床证实的结节或肿块型肺结核患者,共23枚病灶,11枚空洞型,7枚结核瘤型,5枚增生型。采用常规MRI序列与DCE-MRI容量转移常数(Ktrans)、速率常数(Kep)对结节或肿块型肺结核病灶影像特点进行分析。结果:空洞型结核T2WI-FS呈稍高信号团块内见低信号与无信号区,结核瘤呈环形稍高信号团块内见低信号区,增生型结核呈团块状欠均质稍高信号。增强后病灶内T2WI-FS呈稍高信号区明显强化,低信号、无信号区无明显强化。病灶明显强化区Ktrans、Kep平均值分别约(0.087±0.017)min^(-1)、(0.458±0.075)min^(-1),无强化区Ktrans、Kep值约为0。结论:常规MRI联合动态增强MRI(DCE-MRI)能有效反映结节或肿块型肺结核的病理特点,能对其做出准确诊断。

Objective:To explore the diagnostic value of conventional MRI combined with dynamic enhanced MRI(DCE-MRI)in nodular or mass pulmonary tuberculosis.Methods:Sixteen patients with nodular or mass pulmonary tuberculosis confirmed by puncture or clinic were collected.There were 23 lesions,including 11 cavities,7 tuberculomas and 5 hyperplasias.The characteristics of nodular or mass pulmonary tuberculosis lesions were analyzed by using conventional MRI sequence and DCE-MRI volume transfer constant(Ktrans)and rate constant(Kep).Results:T2WI-FS of void tuberculosis showed slightly high signal mass with low signal and no signal area,tuberculoma showed annular slightly high signal mass with low signal area,and proliferating tuberculosis showed clumps with less homogenous slightly high signal.After enhancement,T2WI-FS in the lesion showed obvious enhancement in the slightly high signal area,but no obvious enhancement in the low signal and no signal area.The mean values of Ktrans and Kep were about(0.087±0.018)min^(-1) and(0.458±0.075)min^(-1),respeetively,in the area with obvious enhancement,and about Oin the area without enhancement.Conclusion:Conventional MRI combined with dynamic enhanced MRI(DCE-MRI)can effectively reflect the pathological characteristics of nodular or mass pulmonary tuberculosis and make accurate diagnosis.