CAJ | 학술논문

目的：探讨利用动态增强磁共振成像(dynamic contrast-enhanced MRI， DCE-MRI)的血流动力学双室模型渗透性参数联合ADC值鉴别诊断肺部良恶性病变的应用价值。材料与方法搜集2014年7月至2015年3月在我院行肺部CT增强检查、常规MRI扫描、DWI成像及DCE-MRI扫描的患者共49例(恶性病变29例，良性病变20例)，MRI动态增强扫描采用三维快速容积扫描技术，通过MRI后处理工作站计算病灶的ADC值，血流动力学定量分析软件Omni-Kinetics计算病灶的微血管渗透性参数Ktrans、Kep等。结果 CT联合ADC值、DCE-MRI定量渗透性参数鉴别诊断肺良恶性结节准确率为93.9%；CT联合ADC值鉴别诊断肺良恶性结节准确率为85.7%；CT鉴别肺良恶性结节准确率为75.5%，CT联合ADC值、DCE-MRI定量渗透性参数鉴别肺良恶性结节准确性与CT有显著性差异(P＜0.05)。结论 DCE-MRI定量分析微血管渗透性参数Ktrans、Kep联合ADC值对肺部良恶性病变诊断效能高于CT，而且真正实现定量分析鉴别诊断肺部结节良恶性，值得广泛应用于临床工作。
목적：탐토이용동태증강자공진성상(dynamic contrast-enhanced MRI， DCE-MRI)적혈류동역학쌍실모형삼투성삼수연합ADC치감별진단폐부량악성병변적응용개치。재료여방법수집2014년7월지2015년3월재아원행폐부CT증강검사、상규MRI소묘、DWI성상급DCE-MRI소묘적환자공49례(악성병변29례，량성병변20례)，MRI동태증강소묘채용삼유쾌속용적소묘기술，통과MRI후처리공작참계산병조적ADC치，혈류동역학정량분석연건Omni-Kinetics계산병조적미혈관삼투성삼수Ktrans、Kep등。결과 CT연합ADC치、DCE-MRI정량삼투성삼수감별진단폐량악성결절준학솔위93.9%；CT연합ADC치감별진단폐량악성결절준학솔위85.7%；CT감별폐량악성결절준학솔위75.5%，CT연합ADC치、DCE-MRI정량삼투성삼수감별폐량악성결절준학성여CT유현저성차이(P＜0.05)。결론 DCE-MRI정량분석미혈관삼투성삼수Ktrans、Kep연합ADC치대폐부량악성병변진단효능고우CT，이차진정실현정량분석감별진단폐부결절량악성，치득엄범응용우림상공작。
AbstractObjective:To investigate the application value of quantitative assessment of pulmonary benign and malignant lesions by kinetic parameters of DCE-MRI imaging combined ADC. Materials and Methods:A total of 49 patients with pulmonary lesions (29 malignant lesions, 20 benign lesions) underwent CT contrast enhanced scanning, routine MR scanning, diffusion-weighted imaging MRI (DWI-MRI), and dynamic enhanced MRI. MRI dynamic enhanced scan with 3D rapid volumetric scanning technology. The ADC values of the lesions were calculated by MRI post-processing workstation, and the kinetic parameters such as Ktrans, Kep et al were calculated by the Omni-Kinetics software.Results:DCE-MRI and DWI-MRI technique for the differential diagnosis of benign and malignant nodules of lung nodules accuracy was 93.9%, ADC value combined with CT in the differential diagnosis of lung nodules accuracy was 85.7%, CT in the differential diagnosis of lung nodules accuracy was 75.5%, the accuracy of DCE-MRI combined with DWI-MRI for differentiating benign and malignant pulmonary nodules was significantly different from CT (P<0.05). Conclusion:DCE-MRI hemodynamic parameters such as Ktrans and Kep combined with ADC values of pulmonary benign and malignant lesions were higher than that of CT,and can be used as a quantitative method of differential diagnosis. It should be widely used in clinical work.