摘要
目的探讨动态对比增强磁共振(DCE-MRI)量化肺组织血流动力学对良恶性病变的鉴别诊断价值。方法回顾性选取2016年1月至2017年7月长江大学附属仙桃市第一人民医院行肺部肿块DCE-MRI扫描的患者58例,均经手术或穿刺活检病理证实,采用DCE-MRI容量转移常数(Ktrans)、速率常数(Kep)与血管外细胞外间隙容积比(Ve)对良性病变、恶性病变定量参数展开比较,采用ROC曲线来比较鉴别诊断价值。结果58例患者皆经MRI、DCE-MRI扫描,其中良性病变30例,恶性病变28例,均经手术或病理穿刺证实。恶性病变组Ktrans、Kep平均值分别为0.548±0.048、3.815±3.135,均高于良性病变组(0.042±0.027、1.437±2.745),差异有统计学意义(P<0.05),良、恶性病变Ve比较(0.231±4.015 vs.0.248±0.484),差异无统计学意义(P<0.05)。不同定量参数均具有诊断效能,Ktrans、Kep、Ve AUC分别为0.979、0.742、0.408,当Ktrans值为0.109/min时,诊断敏感度为91%,特异度为87.4%;当Kep值为0.762/min时,诊断敏感度为82.0%,特异度为71.5%,Ve值为0.971/min时,诊断敏感度为80.4%,特异度为40.5%。结论DCE-MRI对肺部组织良恶性病变具有鉴别诊断作用,且可对肺组织血流动力学量化分析。
Objective To investigate the value of dynamic contrast enhancement magnetic resonance imaging(DCE-MRI)in the differential diagnosis of benign and malignant lesions.Methods A total of 58 patients who underwent DCE-MRI scan of the lung mass in Xiantao First People's Hospital Affiliated to Yangtze University between January 2016 and July 2017 were selected retrospectively and confirmed by surgery or biopsy.The DCE-MRI volume transfer constant(Ktrans)and rate constant(Kep)and extravascular extracellular space volume ratio(Ve)were used to compared with quantitative parameters of benign lesions and malignant lesions,and ROC curves were used to compare the diagnostic value.Results All 58 patients underwent MRI and DCE-MRI scans,including 30 benign lesions and 28 malignant lesions,which were confirmed by surgery or pathological puncture.The mean values of Ktrans and Kep were 0.548±0.048 and 3.815±3.135,respectively,which were higher in the malignant lesions than in the benign lesions(0.042±0.027,1.437±2.745),the differences were statistically significant(P<0.05),and there was no significant difference in Ve between benign and malignant lesions(0.231±4.015 vs.0.248±0.484,P<0.05).Different quantitative parameters had diagnostic efficacy and Ktrans,Kep,Ve AUC were 0.979,0.742,0.408,respectively.When Ktrans value was 0.109/min,the diagnostic sensitivity was 91%and the specificity was 87.4%.When the Kep value was 0.762/min,the diagnostic sensitivity was 82.0%and the specificity was 71.5%.When the Ve value was 0.971/min,the diagnostic sensitivity was 80.4%and the specificity was 40.5%.Conclusion DCE-MRI can differentially diagnose the benign and malignant lesions of lung tissue,and can quantitatively analyze the pulmonary hemodynamics.
作者
范磊
丁朝阳
王玉桃
FAN Lei;DING Chao-yang;WANG Yu-tao(Department of Imaging,Xiantao First People's Hospital Affiliated to Yangtze University,Xiantao Hubei 433000,China.)
出处
《临床和实验医学杂志》
2021年第4期443-446,共4页
Journal of Clinical and Experimental Medicine
基金
湖北省自然科学基金面上项目(编号:2017CFB484)。
关键词
肺部肿块
动态对比增强磁共振
良恶性病变
Lung mass
Dynamic contrast enhanced magnetic resonance imaging
Benign and malignant lesions
