摘要
目的分析肺癌MRI图像特点及表观扩散系数(ADC)值在不同类型肺癌鉴别中的价值。资料与方法前瞻性选取经手术病理证实为肺癌的33例患者,均行常规MRI平扫及扩散加权成像(DWI)扫描,b值取50、500、1000 s/mm^2。分析病灶部位、数目及形态、平扫T1WI、T2WI及DWI、ADC图信号特点,比较不同类型肺癌的ADC值。结果 33例患者中,腺癌18例,鳞癌8例,小细胞肺癌7例,非小细胞肺癌26例;中央型肺癌12例,周围型肺癌21例。肿瘤大小为1.3~6.6 cm;病灶不规则形、分叶状或斑片状12例,结节状6例,肿块状15例;边界不清26例,边界相对较清7例。肺癌实性成分在T1WI上呈等或稍低信号,在T2WI上呈等或稍高信号;腺癌在DWI图呈等或高信号,ADC图呈不均匀稍低信号;鳞癌与小细胞癌在DWI图呈高信号,ADC图呈明显低信号;若肿瘤伴有坏死、囊变时,坏死区在DWI图上为稍低或低信号,在ADC图上呈高信。b值取1000 s/mm^2时,腺癌、鳞癌、小细胞肺癌平均ADC值比较差异有统计学意义(P<0.05),腺癌平均ADC值高于鳞癌和小细胞肺癌(P<0.05),鳞癌平均ADC值低于小细胞癌(P<0.05)。中央型与周围型肺癌、小细胞和非小细胞肺癌平均ADC值差异无统计学意义(P>0.05)。结论当b=1000 s/mm^2时,DWI成像在肺腺癌、鳞癌及小细胞癌鉴别诊断中具有重要价值。
Purpose To analyze the characteristics of MRI images of lung cancer and to evaluate apparent diffusion coefficient（ADC） values in differentiating different types of pulmonary carcinoma. Materials and Methods Totally 33 patients with different subtypes of pulmonary carcinoma confirmed by pathology were recruited. All patients underwent conventional MRI and diffusion-weighted imaging with different b values（50, 500, 1000 s/mm^2）. The sites, numbers, morphologies, and the signal intensity of the lesions were analyzed. The ADC values of different types of pulmonary carcinoma were analyzed. Results In 33 patients, there were 18 cases of adenocarcinoma, 8 cases of squamous cell carcinoma, 7 cases of small cell carcinomas; 26 cases of nonsmall cell carcinomas. Twelve cases were central type, and 21 cases were peripheral type. The size of tumors ranged 1.3-6.6 cm, with irregular shape, lobulated or patchy in 12 cases, nodular in 6 cases, and mass of 15 cases. Twenty-six cases revealed ill-defined boundary, and 7 cases of relative welldefined boundary. The solid components of tumors showed iso- or slightly hypointensity on T1WI, iso- or slightly hyperintensity on T2WI. The adenocarcinomas showed isoor hyperintnsity on DWI, while heterogeneous low signal intensity on ADC maps. The squamous cell carcinomas and small-cell carcinomas showed high signal intensity on the DWI maps, while significant low signal intensity on ADC maps. The necrosis and cystic degeneration showed the hypointensity on DWI and hyperintensity on ADC map. There were significant differences on mean ADC values of adenocarcinoma, squamous cell carcinoma and small cell carcinoma at b value =1000 s/mm^2（P〈0.05）. The mean ADC value of adenocarcinoma was higher than that of squamous cell carcinoma and small cell carcinoma（P〈0.05）. The mean ADC value of squamous cell carcinoma was lower than that of small cell carcinoma（P〈0.05）. There was no significant difference of the mean ADC value among the central type, peripheral type, small cel
出处
《中国医学影像学杂志》
CSCD
北大核心
2016年第6期459-463,共5页
Chinese Journal of Medical Imaging
基金
福建省卫生系统中青年骨干人才培养项目资助计划(2013-ZQN-JC-5)
关键词
肺肿瘤
磁共振成像
弥散
扩散加权成像
表观扩散系数
病理学
外科
诊断
鉴别
Lung neoplasms
Diffusion magnetic resonance imaging
Diffusion weighted imaging
Apparent diffusion coefficient
Pathology
surgical
Diagnosis
differential
