CAJ | 학술논문

目的：：探讨MRI动态增强成像( DCE-MRI)在肺孤立性良恶性实性病变中的诊断价值。方法：采用3.0 T MRI对2014年7月-2015年2月本科室胸部CT发现的56例肺孤立实性病变进行动态增强扫描,其中良性病变12例,周围型肺癌44例,分别测量病灶的最大相对强化比、最大强化值,获得时间-信号曲线( TIC),比较肺良恶性病变的ROC曲线下面积( AUC),并与CT诊断结果进行比较。结果：周围型肺癌与良性病变的最大相对强化比差异无统计学意义( P>0.05)；周围型肺癌与良性病变的最大强化值分别为108.26±30.03和79.01±32.46(P<0.05)。最大强化值的ROC曲线下面积为0.74,最大强化值96.35时诊断效能最高,敏感性和特异性分别为72.72％和75.00％。周围型肺癌的时间-信号强度曲线以A和B型曲线类型为主,占84.09％(37/44)；良性病变以C和D型曲线类型为主,占58.33％(7/12)。 MRI与CT诊断准确率分别为：80.36％(45/56)及83.93％(47/56)(P>0.05)。结论：病灶动态增强MRI最大强化值及时间-信号强度曲线对肺良恶性实性病变的鉴别有一定价值。
목적：：탐토MRI동태증강성상( DCE-MRI)재폐고립성량악성실성병변중적진단개치。방법：채용3.0 T MRI대2014년7월-2015년2월본과실흉부CT발현적56례폐고립실성병변진행동태증강소묘,기중량성병변12례,주위형폐암44례,분별측량병조적최대상대강화비、최대강화치,획득시간-신호곡선( TIC),비교폐량악성병변적ROC곡선하면적( AUC),병여CT진단결과진행비교。결과：주위형폐암여량성병변적최대상대강화비차이무통계학의의( P>0.05)；주위형폐암여량성병변적최대강화치분별위108.26±30.03화79.01±32.46(P<0.05)。최대강화치적ROC곡선하면적위0.74,최대강화치96.35시진단효능최고,민감성화특이성분별위72.72％화75.00％。주위형폐암적시간-신호강도곡선이A화B형곡선류형위주,점84.09％(37/44)；량성병변이C화D형곡선류형위주,점58.33％(7/12)。 MRI여CT진단준학솔분별위：80.36％(45/56)급83.93％(47/56)(P>0.05)。결론：병조동태증강MRI최대강화치급시간-신호강도곡선대폐량악성실성병변적감별유일정개치。
Objective:To investigate the diagnostic value of dynamic contrast enhanced MR imaging ( DCE-MRI) in the diagnosis of benign and malignant lesions of the lung. Methods:A total of 56 patients with solitary pulmonary lesions (including 44 with peripheral lung cancer and 12 with benign lesions) detected by chest CT scan in our department between July 2014 and February 2015 were enrolled in this prospective study. The 3.0T DCE-MRI images were analyzed by measuring the max relative enhancement values and the max enhancement values. The time-signal intensity curve was generated. The area under the ROC curve ( AUC ) of benign and malignant lung lesions were calculated and compared with diagnostic accuracy of CT. Results: There was no significant difference in the max relative enhancement values between peripheral lung cancers and benign lesions (P>0.05). The maximum enhancement value was 108.26±30.03 in peripheral lung cancers versus 79.01±32.46 in the benign lesions, with a statistically significant difference between the both (P<0.05). The AUC of the maximum enhancement values was 0. 74. With a cut-off value of 96. 35, best diagnostic efficiency of DCE-MRI was achieved, yielding 72. 72% sensitivity and 75. 00% specificity. The time-intensity curve of peripheral lung cancer were predominantly featured by types A and B curves which accounted for 84. 09% of the total images (37/44), whereas the curve of benign lesions by types C and D curves which accounted for 58.33% of the total (7/12). The diagnostic accuracy of MRI and CT was 80.36% (45/56) and 83.93% (47/56) respectively (P>0. 05 ) . Conclusion: The maximum enhancement value and time signal intensity of DCE-MRI curve will be helpful in the differentiation of benign and malignant lesions of the lung.