孤立性肺结节MR动态增强的初步研究

Dynamic enhancement MR in differential diagnosis of solitary pulmonary nodules

目的:探讨MR动态增强对孤立性肺结节的鉴别诊断价值。方法:对47例孤立性肺结节行MR动态增强,绘制MR动态增强时间-信号强度曲线,测量病灶的强化峰值(PH)、强化斜率(F)、最大强化率(Emax)及1、2、3、4、5、6 min时的信号强化率(E1、E2、E3、E4、E5、E6)。结果:恶性结节及炎性结节的强化程度明显高于良性结节,恶性结节及炎性结节的PH、SS、Emax、E1～E6均明显高于良性结节(P<0.01)。恶性结节与炎性结节均强化明显,但二者之间的PH、SS、Emax、E1～E6无明显差异(P>0.05)。结论:MR动态增强能反映病灶的血流动力学信息,对良恶性结节的鉴别诊断有较高的临床应用价值。

Objective:To evaluate the diagnostic efficacy of contrast enhanced dynamic MRI in differentiating benign and malignant solitary pulmonary nodules(SPNs). Methods: A prospective study was undertaken in 47 patients with SPNs using contrast enhanced dynamic MRI. Patterns of Time-Signal intensity curve (T-SI Curve) were made. Peak height (PH), steep slope (SS) , maximum enhancement (Emax) and the enhancement rates of signal intensity at the first (E1) , second (E2), third (E3), fourth (E4), fifth (E5), sixth (E6) minutes of T-SI curve were calculated. Results: Malignant nodules and inflammatory nodules enhanced significantly more than benign nodules;malignant nodules and inflammatory nodules showed obviously higher PH,SS,Emax and E1-E6 values than that of benign nodules(P<0. 01). Malignant nodules and inflammatory nodules enhanced obviously,but there were no significant differences in PH,SS,Emax and E1-E6 values between malignant nodules and inflammatory nodules(P>0. 05). Conclusion:Contrast enhanced dynamic MR imaging can provide SPNs hemodynamic information and is proved to be a valuable diagnostic method for differentiating SPNs.