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目的探讨定量动态对比增强MRI(DCE-MRI)对肺部肿块良、恶性的鉴别诊断价值。方法 71例肺部肿块患者(共71个肿块)行DCE-MRI检查,经病理证实为良性肿块25个(良性组)和恶性肿块46个(恶性组)。测量定量参数容量转移常数(Ktrans)、速率常数(Kep)和血管外细胞外间隙容积比(ve),绘制受试者工作特征曲线,评价各参数值的诊断效能。结果恶性组肿块Ktrans和Kep值均高于良性组肿块[(0.269±0.086)min-1 vs.(0.191±0.082)min-1和(0.937±0.461)min-1 vs.(0.573±0.266)min-1](P<0.01)。恶性组肿块ve值与良性组肿块相仿(0.327±0.149vs.0.389±0.203)(P>0.05)。Ktrans、Kep和ve曲线下面积分别为0.736、0.724和0.403,敏感度分别为87%、41%和85%,特异度分别为52%、96%和20%。结论 DCE-MRI参数Ktrans、Kep值有助于鉴别诊断肺部肿块。
Objective To investigate the diagnostic value of quantitative dynamic contrast-enhanced MRI (DCE-MRI) in differential diagnosis of benign and malignant pulmonary masses. Methods A total of 71 masses of 71 patients with pulmonary masses underwent DCE-MRI. Twenty-five benign masses and 46 malignant masses were confirmed by pathology. Quantitative parameters such as Ktrans, Kep and ve were plotted, and the working characteristics of the subjects were plotted to evaluate the diagnostic efficacy of each parameter. Results Ktrans and Kep values in malignant group were significantly higher than those in benign group [(0.269 ± 0.086) min-1 vs. (0.191 ± 0.082) min-1 and (0.937 ± 0.461) min-1 vs. (0.573 ± 0.266) min -1] (P <0.01). The values of ve in malignant group were similar to those in benign group (0.327 ± 0.149 vs. 0.089 ± 0.203) (P> 0.05). The areas under the Ktrans, Kep and ve curves were 0.736, 0.724 and 0.403, with sensitivities of 87%, 41% and 85%, respectively, with a specificity of 52%, 96% and 20%, respectively. Conclusions Ktrans and Kep values of DCE-MRI parameters are helpful for the differential diagnosis of lung masses.