摘要
目的应用自由呼吸径向采集K空间放射填充容积内插成像序列(Star VIBE)和读出方向分段采样技术(Resolve)-扩散加权成像(DWI)技术联合体素内不相干运动(IVIM)序列进行肺部成像,探讨其在肺内占位性病变诊断和非小细胞肺癌免疫治疗疗效评价方面的价值。方法病理确诊肺内结节或肿块50例,行磁共振成像(MRI)检查后分为2组观察,A组为常规序列组,即传统MRI序列包括T_(1)加权成像(T_(1)WI)及T_(1)WI-FS、T_(2)加权成像(T_(2)WI)及T_(2)WI-FS、增强扫描;B组为新技术序列组,在A组序列基础上,增加Star VIBE、Resolve-DWI;2组图像观察时间间隔为2周,由2名高年资MRI医师采用5分类法进行评价和诊断,分析2组方法对肺内占位性病变的诊断效能。确诊NSCLC行免疫治疗的病例,治疗后3周期行MRI检查,分为2组进行数据分析,C组为治疗有效组,D组为治疗无效组,分析IVIM数据指标免疫治疗前后的变化和治疗效果之间的关系。MRI检查主要序列包括T_(1)WI、T_(2)WI及T_(2)WI-FS、Star Vibe、Resolve-DWI、IVIM,其中IVIM设定0、40、60、100、150、200、500、800、1000、2000共10个b值。结果肺内占位50例,恶性肿瘤38例(肺癌35例、转移瘤3例),良性病变12例。经过分析,A组诊断的准确度、特异度、灵敏度分别为0.76、0.58、0.82,B组诊断的准确度、特异度、灵敏度分别为0.90、0.83、0.92,B组高于A组,且2组间的准确度、特异度、灵敏度差异有统计学意义(P<0.05)。非小细胞肺癌(NSCLC)接受免疫治疗的20例,C组13例,D组7例。C组IVIM参数表观扩散系数(ADC)、f、D~*值免疫治疗前分别为(1.08±0.21)×10^(-3)mm^(2)/s、(45±14)%、(28±12)×10^(-3)mm^(2)/s,治疗后分别为(1.31±0.20)×10^(-3)mm^(2)/s、(63±24)%、(44±17)×10^(-3)mm^(2)/s,经过统计分析,2组治疗前后ADC、f、D~*值之间的差异有统计学意义,治疗后的数值高于治疗前。C组D值治疗前(1.18±0.63)×10^(-3)mm^(2)/s,治疗后(1.53±0.76)×10^(-3
Objective To study the value of Star VIBE and Resolve-DWI combined with IVIM in the diagnosis of pulmonary space occupying lesions and the response of immunotherapy for non-small cell lung cancer.Methods50 cases′pulmonary nodules or masses confirmed by pathology underwent MRI examination.All cases were divided into two groups for observation.Group A was the conventional sequence group included T_(1)WI and T_(1)WI-FS,T_(2)WI and T_(2)WI-FS,contrast scanning;Group B was the new technology sequence group,included Star VIBE、Resolve-DWI in addition to the group A sequence.The images were readed and evaluated by two senior MRI radiologists used the 5-classification method two weeks apart.The efficiency of the two groups in the diagnosis of pulmonary space occupying lesions were analyzed.In addition,the patients confirmed to NSCLC who received immunotherapy underwent MRI examination after three cycles treatment.The patients of NSCLC were divided into two groups,group C was the effective group and group D was the ineffective group.The relationship between the changes of IVIM datas before and after immunotherapy and the treatment effect was analyzed.The main sequences of MRI examination included T_(1)WI,T_(1)WI-FS,T_(2)WI,T_(2)WI-FS,Star Vibe,Resolve-DWI and IVIM.The b values of IVIM sequence were setted 0,40,60,100,150,200,500,800,1000 and 2000.Results Fifty cases with pulmonary space occupying lesions included 38 malignant tumors(35 cases with lung cancer and 3 cases with metastasis)and 12 benign lesions.According to analysis,the diagnostic accuracy,specificity and sensitivity of group A were 0.76,0.58 and 0.82 respectively.The diagnostic accuracy,specificity and sensitivity of group B were 0.90,0.83 and 0.92 respectively.The value of group B was higher than group A,and there were statistical difference of them(P<0.05).20 cases with NSCLC received immunotherapy included 13cases in group C and 7 cases in Group D.The ADC,F and D^(*)values of IVIM in group C were(1.08±0.21)×10^(-3)mm^(2)/s,(45±15)%and(28±12)×10^(-
作者
王刚
吴依芬
余芬芬
黄小兰
王朝阳
范宪淼
张坤林
Wang Gang;Wu Yifen;Yu Fenfen;Huang Xiaolan;Wang Chaoyang;Fan Xianmiao;Zhang Kunlin(Department of Radiology,Dongguan People′s Hospital,Guangdong 523059,China;不详)
出处
《实用医学影像杂志》
2022年第4期325-330,共6页
Journal of Practical Medical Imaging
基金
广东省中医药局课题(20202220)
广东省医学科研基金指令性课题(C2019093)。
关键词
癌
非小细胞肺
弥散磁共振成像
体素内不相干运动
读出方向分段采样技术
K空间采样
Carcinoma,non-small-cell lung
Diffusion magnetic resonance imaging
Intravoxel incoherent motion
Readout segmentation of long variable echo-trains
K-space sampling
