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1、实用放射学杂志2015年6月第31卷第6期JPractRadiol,Jun.2015,Vol.31,No.6·925·磁共振DWI鉴别实性孤立性肺结节价值研究任进军,赵宝宏,訾学荣,张玉环,迟红卫,王淑萍,徐倩,陈艳芳(华北石油总医院医学影像科,河北任丘062550)摘要:目的评价MR扩散加权成像(DWI)对实性孤立性肺结节(SPN)的鉴别诊断价值。方法经手术、活检或临床治疗随访后证实的42例SPN患者,其中恶性25例,良性17例,全部行MR胸部常规T1WI、T2WI和DWI检查,b值选择300,500,2和1000s/m
2、m2。分别测量不同b值时的表观扩散系数(ADC)值和信号强度。结果良、恶性SPN的ADC值和信号800s/mm强度均随b值增加而呈逐渐下降趋势。良、恶性SPN在b值=500s/mm2时,其ADC值有统计学意义(P);而b500=0.03<0.05值在300~1000s/mm2时,其信号强度值均有统计学意义(P,P,P,P300<0.001500=0.03<0.05800=0.01<0.051000=0.02<0.05)。结论DWI的信号强度和ADC值对良、恶性SPN鉴别诊断均具有重要临床意义,信号强度值的诊断效能优于ADC
3、值。关键词:磁共振成像;扩散加权成像;孤立性肺结节DOI:10.3969/j.issn.1002-1671.2015.06.011中图分类号:R445.2;R563文献标志码:A文章编号:1002-1671(2015)06-0925-04ThestudyofdistinguishingsolidsolitarypulmonarynodulewithdiffusionweightedimagingRENJinjun,ZHAOBaohong,ZIXuerong,ZHANGYuhuan,CHIHongwei,WANGShupin
4、g,XUQian,CHENYanfang(DepartmentofRadiology,theGeneralHospitalofNorthern-ChinaOilField,Renqiu,HebeiProvince062550,China)Abstract:ObjectiveToevaluatethevalueofdiffusionweightedimaging(DWI)indistinguishingthesolidsolitarypulmonarynodule(SPN).Methods42patientswithSPN(
5、malignantin25andbenignin17)whowereconfirmedbyoperation,biopsyorfollowupaftertreatmentunderwentroutinechestT1WI,T2WIandDWI.Thebvalueswerechosenas300,500,800and2,andthecorrespondingapparentdiffusioncoefficient(ADC)valuesandthesignalintensity(SI)wererespectively1000s
6、/mmmeasured.ResultsTheADCvaluesandSIofbenignandmalignantSPNsweregraduallyreducedwithincreasingbvalue.TheADC2(P),meanwhilevaluebetweenbenignandmalignantSPNswasstatisticallysignificantwithbvalueof500s/mm500=0.03<0.052(P,P,P,theSIwasstatisticallysignificantwithbvalue
7、sfrom300to1000s/mm300<0.001500=0.03<0.05800=0.01<0.05P1000=0.02<0.05).ConclusionBothSIandADCvalueofDWIplayimportantroleindistinguishingbenignandmalignantSPNs,andthediagnosticefficiencyofSIissuperiortoADCvalue.Keywords:magneticresonanceimaging;diffusionweightedimag
8、ing;solitarypulmonarynoduleMR扩散加权成像(diffusionweightedimaging,1资料与方法DWI)是磁共振功能成像方法中的一种,也是目前能在1.1病例选择收集2013-01—2014-10SPN患活体上进行水分子扩散测量及成像的唯一方法,可以者42例,其中男2
