CAJ | 학술논문

目的：探讨MRI技术对肺结节的鉴别诊断作用。方法收集肺结节病例54例，首先行CT检查；然后行动态增强MRI（dynamic Contrast Enhanced MRI ，DCE-MRI）检查，并计算肺结节最大增强线性斜率（steepest slope，SS）、强化峰值（peak height，PH）、增强后1 min、2 min、4 min的信号强度改变率（E1、E2、E4），同时进行弥散加权成像MRI（diffu-sion weighted imaging MRI ，DW-MRI），对肺结节进行良恶性鉴别。结果恶性结节和炎症性结节较结核球、错构瘤、囊肿等良性结节有更高的SS、PH及E1、E2、E4，有部分恶性结节与炎性结节的上述指标重叠，同时结合DW-MRI可以较好地鉴别恶性结节及炎性结节。 DCE-MRI联合DW-MRI技术鉴别肺良恶性结节灵敏度为92．0％，特异性为89．7％；CT鉴别肺良恶性结节灵敏度为76．0％，特异性为72．4％。 DCE-MRI联合DW-MRI在鉴别肺良恶性结节上，显著优于CT（ P＝0．020）。结论 DCE-MRI联合DW-MRI对肺良恶性结节的鉴别诊断作用优于CT，值得临床推广。
목적：탐토MRI기술대폐결절적감별진단작용。방법수집폐결절병례54례，수선행CT검사；연후행동태증강MRI（dynamic Contrast Enhanced MRI ，DCE-MRI）검사，병계산폐결절최대증강선성사솔（steepest slope，SS）、강화봉치（peak height，PH）、증강후1 min、2 min、4 min적신호강도개변솔（E1、E2、E4），동시진행미산가권성상MRI（diffu-sion weighted imaging MRI ，DW-MRI），대폐결절진행량악성감별。결과악성결절화염증성결절교결핵구、착구류、낭종등량성결절유경고적SS、PH급E1、E2、E4，유부분악성결절여염성결절적상술지표중첩，동시결합DW-MRI가이교호지감별악성결절급염성결절。 DCE-MRI연합DW-MRI기술감별폐량악성결절령민도위92．0％，특이성위89．7％；CT감별폐량악성결절령민도위76．0％，특이성위72．4％。 DCE-MRI연합DW-MRI재감별폐량악성결절상，현저우우CT（ P＝0．020）。결론 DCE-MRI연합DW-MRI대폐량악성결절적감별진단작용우우CT，치득림상추엄。
Objective To investigate the role of MRI in differential diagnosis of pulmonary nodules .Methods 54 cases of pulmonary nodule patients were collected ,and received CT examination and dynamic contrast-enhanced MRI ( DCE-MRI) ,and calculated pulmonary nodules steepest slope (SS),peak height(PH),E1,E2,E4,At the same time diffusion-weighted imaging MRI( DW-MRI) was used for differential diagnosis of benign and malignant pulmonary nodules .Results Malignant nodules and inflammatory nodules showed higher SS,PH,E1,E2 and E4 than that of the tuberculoma,hamartoma and cyst.The above indexes of parts of malignant nodules and inflammatory nodules had overlap ,combined with DW-MRI technology could distinguish the ma-lignant nodules and inflammatory nodules .DCE-MRI and DW-MRI technique for the differential diagnosis of malignant and benign pulmonary nodules sensitivity was 92%,specificity was 89.7%;CT in the differential diagnosis of benign and malignant pulmona-ry nodules sensitivity was 76%,specificity was 72.4%.DCE-MRI combined with DW-MRI in the differential diagnosis of malig-nant and benign pulmonary nodules was superior to CT (P=0.02).Conclusion DCE-MRI combined with DW-MRI in the dif-ferential diagnosis of malignant and benign pulmonary nodules is better than CT ,it is worthy of clinical application .