摘要
目的探究小视野扩散加权成像(r-FOV DWI)联合T_(2)WI压脂能否提高肺实性结节的良恶性鉴别诊断能力。方法回顾性分析108例患者的临床及胸部MRI影像资料。在压脂T_(2)WI沿结节边缘手动绘制兴趣体积,获得病灶体积、平均信号强度及信号强度标准差,定义T_(2)对比度(T_(2)CR)为肺结节的平均T_(2)信号强度与菱形肌的T_(2)信号强度的比率,在r-FOV ADC图上绘制病灶的兴趣区获得平均ADC值。建立受试者工作特征曲线(ROC)确定参数的诊断效能。结果肺癌ADC值[(1.08±0.33)×10^(-3)mm^(2)/s]低于良性肺结节[(1.82±0.60)×10^(-3)mm^(2)/s](P<0.001),肺癌T_(2)CR(1.91±0.83)低于良性肺结节(2.66±0.94)(P<0.001)。当ADC值取1.34×10^(-3)mm^(2)/s时,AUC为86.2%,敏感度80.4%,特异度79.0%。当T_(2)CR取2.25时,AUC为72.8%,敏感度72.6%,特异度64.9%。ADC值和T_(2)CR联合检测的敏感度82.4%,特异度87.7%,AUC 93.1%。结论r-FOV DWI联合T_(2)WI压脂后能提高鉴别肺实性结节良恶性的诊断效能。
Objective To determine the value of reduced field-of-view diffusion-weighted imaging(r-FOV DWI)and fat-suppressed T_(2)-weighted MR imaging(T_(2)WI)for differential diagnosis of benign and malignant solid pulmonary nodules(SPN).Methods The clinical record and chest MRI of 108 patients with pulmonary nodules were analyzed retrospectively.Volume and mean T_(2)signal intensities(SI)of pulmonary nodules were obtained by drawing free-hand volumes of interest on lesions,which were detected visually on the T_(2)WI.T_(2)contrast ratio(T_(2)CR)was defined as the ratio of mean T_(2)SI of a pulmonary nodule divided by the T_(2)SI of the rhomboid muscle.Mean apparent diffusion coefficient(ADC)values of the regions of interest on the r-FOV ADC maps were measured.Receiver operating characteristic(ROC)curve analysis was performed to determine the diagnostic efficacy of parameters.Results The ADC[(1.08±0.33)×10^(-3)mm^(2)/s]of lung cancer was significantly lower(P<0.001)than that[(1.82±0.60)×10^(-3)mm^(2)/s]of benign pulmonary nodules(BPN).The T_(2)CR(1.91±0.83)of lung cancer was significantly lower(P<0.001)than that(2.66±0.94)of BPN.Using cutoff ADC value of 1.34×10^(-3)mm^(2)/s,the area under ROC curve(AUC)was 86.2%with 80.4%sensitivity and 79.0%specificity for differentiating benign from malignant nodules.Using cutoff T_(2)CR value of 2.25,the AUC was 72.8%with 72.6%sensitivity and 64.9%specificity.Combined ADC and T_(2)CR improved the sensitivity to 82.4%,the specificity to 87.7%,and the AUC to 93.1%.Conclusion Combined r-FOV DWI and fat-suppressed T_(2)WI improves the differential diagnosis of SPN.
作者
陆杰
徐海
沈杰
高叶祺
王博煊
俞同福
LU Jie;XU Hai;SHEN Jie;GAO Ye-qi;WANG Bo-xuan;YU Tong-fu(Department of Radiology,The First Affiliated Hospital with Nanjing Medical University,Jiangsu 210029,China)
出处
《影像诊断与介入放射学》
2022年第6期416-421,共6页
Diagnostic Imaging & Interventional Radiology
关键词
肺结节
扩散加权成像
小视野
压脂T_(2)加权
Pulmonary nodule
Diffusion-weighted imaging
Reduced field of view
Fat suppression T_(2)-weighted imaging
