摘要
目的探讨磁共振弥散序列成像及表观扩散系数(ADC)值测量对肺结节的诊断和鉴别诊断价值,并确定能精确反映肺结节扩散特性的b值及ADC阈值。方法33例周围型单发肺结节患者,根据良恶性分为肺癌组(n=26)和良性节结组(n=7)。运用SE-EPI技术,选取3个不同b值:600、800、1000 s/mm^2。进行横轴位DWI扫描.计算b=0~600、0~800、400~1000 s/mm2时的ADC值,分别计算并比较b=400、600、800、1000 s/mm2时DWI图像中肿瘤的SNR,确定最佳b值,运用ROC曲线获取ROC曲线下面积,来进行诊断性能比较。结果肺癌组600和1000 s/mm^2ADC值低于0和600、0和800、0和1000 s/mm^2组,0和1000 s/mm^2组ADC值低于0和600 s/mm2组,差异均有统计学意义(P<0.05)。诊断性能最佳的是b=800 s/mm^2时所得到的ADC值,运用ADC值鉴别诊断良恶性肺结节的最佳阈值为1.366×10-3mm^2/s,其所对应的敏感度和特异性比其余各b值组更高,分别为80.8%、71.4%。结论诊断性能最大的为b=800 s/mm^2时所得到的ADC值,鉴别良恶性肺结节的ADC最佳阈值为1.366×10-3mm^2/s,这两组数据对鉴别诊断良恶性肺结节有很高的价值。
Objective To investigate the application value of magnetic resonance dispertion sequence imaging and apparent diffusion coefficient(ADC)in diagnose and differential diagnosis of pulmonary nodule,and to determine the optimal diffusion sensitivity coefficient(b)and ADC threshold that can accurately reflect the diffusion characteristics of lung nodules.Methods A total of 33 patients with peripheral single pulmonary nodule were enrolled in the study,who were divided into lung cancer group(n=26)and benign pulmonary nodule group(n=7).Using SE-echo-planar imaging(SE-EPI)technique to choose three different diffusion sensitivity coefficients(b):600,800,1,000s/mm2,and the horizontal axis DWI scanning was performed to calculate the ADC value,calculate and compare the signal-to-noise ratio(SNR)of the tumor in DWI image at b=400,600,800,1,000s/mm2 to determine the best b value.Moreover to use the ROC curve to obtain the area under ROC curve to compare the diagnostic performance.Results The ADC mean value in 600 and 1,000s/mm^2 in lung cancer group was significantly lower than that in 0~600,0~800,400~1,000s/mm^2,which in 0~1,000s/mm was significantly lower than that in 0~600s/mm^2(P<0.05).The ADC value obtained in b=800s/mm^2 had optimal diagnostic performance.The optimal threshold of ADC in differential diagnosis of benign and malignant pulmonary nodule was 1.366×10-3mm2/s,and the sensitivity and specificity was 80.8%and 71.4%respectively.Conclusion The ADC value obtained in b=800s/mm^2 has the optimal diagnostic performance,and the.The optimal threshold of ADC in differential diagnosis of benign and malignant pulmonary nodule is 1.366×10-3mm^2/s,and the two sets data are of important significance for the differential diagnosis of benign and malignant pulmonary nodule.
作者
杨雪
孟庆军
宋翔
时高峰
于淑靖
YANG Xue;MENG Qingjun;SONG Xiang(Department of CT,Central Hospital of Cangzhou City,Hebei,Cangzhou 061000,China)
出处
《河北医药》
CAS
2020年第2期208-211,共4页
Hebei Medical Journal
