CAJ | 학술논문

目的：利用动态增强 MRI 的血流动力学参数评估孤立性肺结节，并探讨该方法在鉴别肺结节的良恶性的应用价值。方法：搜集2013年8月-2014年5月期间在本院行动态增强 MRI 扫描的孤立性肺结节的患者47例（其中恶性结节31例，良性结节16例）。先行全肺常规平扫，然后利用三维快速容积扫描技术（LAVA）对病灶和纵隔进行灌注扫描，测量注药前和注药后15期病灶的信号强度，拟合得到时间-信号曲线（T-SI 曲线），计算注药后第1、2、4min 信号增强比（SI1％、SI2％、SI4％）和最大信号增强比（MER），达到峰值信号的时间（Tmax），最大上升斜率（SS）以及廓清率（wash-out）。结果：恶性结节的平均强化量 ME、SI1％、SI2％、SI4％、MER、SS、Tmax 均与良性结节具有显著性差异（P ＜0．05），其中 SI1％、SI2％、SI4％、MER、Tmax、SS 具有非常显著统计学差异（P ＜0．01）。T-SI 曲线可以分为4种类型，恶性结节以 A 型和 B 型为主，占30/31，良性结节主要是 B 型、C 型为主，占12/16，D 型曲线能够确定结节为良性。结论：利用DCE-MRI 可以反映血流动力学参数，作为鉴别恶性病变、良性病变的有潜在前景的检查方法。
목적：이용동태증강 MRI 적혈류동역학삼수평고고립성폐결절，병탐토해방법재감별폐결절적량악성적응용개치。방법：수집2013년8월-2014년5월기간재본원행동태증강 MRI 소묘적고립성폐결절적환자47례（기중악성결절31례，량성결절16례）。선행전폐상규평소，연후이용삼유쾌속용적소묘기술（LAVA）대병조화종격진행관주소묘，측량주약전화주약후15기병조적신호강도，의합득도시간-신호곡선（T-SI 곡선），계산주약후제1、2、4min 신호증강비（SI1％、SI2％、SI4％）화최대신호증강비（MER），체도봉치신호적시간（Tmax），최대상승사솔（SS）이급곽청솔（wash-out）。결과：악성결절적평균강화량 ME、SI1％、SI2％、SI4％、MER、SS、Tmax 균여량성결절구유현저성차이（P ＜0．05），기중 SI1％、SI2％、SI4％、MER、Tmax、SS 구유비상현저통계학차이（P ＜0．01）。T-SI 곡선가이분위4충류형，악성결절이 A 형화 B 형위주，점30/31，량성결절주요시 B 형、C 형위주，점12/16，D 형곡선능구학정결절위량성。결론：이용DCE-MRI 가이반영혈류동역학삼수，작위감별악성병변、량성병변적유잠재전경적검사방법。
Objective:This study is to investigate if kinetic parameters of DCE-MR imaging may help to differentiate ma-lignant and benign SPNs.Methods:A total of 47 patients with SPNs (31 malignant nodules and 16 benign nodules)under-went routine SE/T1WI and FSE/T2WI scanning and liver acquisition of volume accelaration (LAVA)DCE-MRI exams. Two experienced radiologists measured the signal intensity of the mass in 15 phases,generating temporal signal curves.The following analysis were taken:signal at 1,2,4 minutes after bolus injection and the maximum enhancement ratio (MER);time at the maximum enhancement ratio (Tmax);the steepest rising slope of time-signal curves;mean enhancement value and washout ratio.Results:It was found that ME,SI1%,SI2%,SI4%,MER,SS,Tmax for the malignant group were signif-icantly different from those for the benign SPN group (P <0.05)and SI1%,SI2%,SI4%,MER,Tmax,SS were much sig-nificantly different (P <0.01).The temporal-signal curves were classified into four types.The results showed that type A and B curves were main types for malignant nodules,whereas type B and C mainly occur in the case of benign nodules.In type D three were all benign tumors.Conclusion:DCE-MRI may be a viable tool in differentiating malignant SPNs from be-nign SPNs with the use of kinetic parameters.