摘要
目的探讨磁共振扫描中全病变表观弥散系数(apparent diffusion coefficient,ADC)直方图在肺部良恶性病变鉴别中的价值,并筛选出最佳诊断参数值。方法收集经肺部活检穿刺或手术后病理证实的肺癌22例、肺部良性病变(主要为肺炎、结核)17例,所有患者均在治疗前接受肺部弥散加权成像(diffusion weighted imaging,DWI)检查,包括6个b值(b=0,50,150,400,600,800s/mm^2)测量全病变ADC直方图参数,以及ADC偏度、峰度、熵、平均数、中位数、标准差、病变体积和ADC第5,10,15,30,50,70,90百分位数(ADC5th、ADC10th、ADC15th、ADC30th、ADC50th、ADC70th、ADC90th),并分析2组直方图参数有无差异。结果肺癌组ADC直方图参数偏度、峰度、平均数、标准差、ADC50th、ADC70th、ADC90th均低于肺部良性病变组,差异有统计学意义(P<0.05);用ADC直方图参数绘制受试者工作特征(receiver operator characteristic,ROC)曲线,计算曲线下面积(area under curve,AUC)。ADC标准差的诊断效能最高,当ADC标准差为0.810(×10^(-3) mm^2/s)时,AUC为0.789,特异度为94.1%,敏感度为68.2%;其次为ADC90th,当ADC90th为1.940(×10^(-3) mm^2/s)时,AUC为0.785,特异度为94.1%,敏感度为54.5%。结论全病变ADC直方图可用于鉴别肺部良恶性病变,ADC标准差诊断效能最高。
Objective To explore the value of the whole-lesion apparent diffusion coefficient（ADC）value histogram of DWI examination in the differentiation of malignant and benign lung lesions,and choose the best diagnostic parameters.Methods The 22 lung cancer and 17 benign lung lesions（including pneumonia and tuberculosis）,which received lung biopsy or surgical operation and had pathology results were collected.Before treatment,all patients received lung DWI examination with 6 bvalues：b=0,50,150,400,600,800 s/mm2.The whole-lesion ADC value histogram and related parameters was calculated,including skewness,kurtosis,entropy,ADC mean value,ADC median value,lesion volume,ADC value standard deviation,and the 5 th,10 th,15 th,30 th,50 th,70 th,90 th ADC value percentile.And the differences between the 2 groups were compared.Results Lung cancer group parameters of ADC values histogram of skewness,kurtosis,mean,standard deviation,ADC50 th,ADC70 th,ADC90 th were lower than lung benign lesions,the difference was statistically significant（P〈0.05）.Receiver operator characteristic curve（ROC）was plotted with ADC histogram parameters to calculate area under curve（AUC）.The diagnostic efficacy of the ADC standard deviation was the highest.When the ADC standard deviation was 0.810（×10-3 mm2/s）,the AUC was 0.789,the specificity was94.1%,and the sensitivity was 68.2%.When ADC90 th is 1.940（×10-3 mm2/s）,AUC is 0.785,specificity is 94.1%,and sensitivity is 54.5%.Conclusion The whole-lesion apparent diffusion coefficient（ADC）value histogram can be used in the differentiation of malignant and benign lung lesions.Among the parameters, ADC value standard deviation have the best diagnostic performance.
作者
张莹
耿广
侯志华
刘玉芳
魏晗
ZHANG Ying;GENG Guang;HOU Zhi-hua;LIU Yu-fang;WEI Han(Department of Radiology,Hebei Chest Hospital,Shijiazuang 050041,China)
出处
《河北医科大学学报》
CAS
2018年第12期1424-1427,共4页
Journal of Hebei Medical University
基金
河北省医学科学研究重点课题(20170427)
关键词
肺肿瘤
弥散磁共振成像
曲线下面积
lung neoplasms
diffusion weighted imaging
area under curve
