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目的探讨肺部良性及恶性肿瘤患者MRI弥散加权成像(diffusion-weighted imaging,DWI)不同b值下表观扩散系数(apparent diffusion coefficient,ADC)和DWI信号强度(signal intensity,SI)差异,探讨其在肺部良、恶性肿瘤鉴别诊断中的价值。方法肺部肿瘤患者50例,其中恶性肿瘤34例(恶性肿瘤组),良性肿瘤16例(良性肿瘤组),均于术前行MRI平扫及多b值(b值分别为300、500、800 s/mm~2)DWI检査,比较2组肺部病变实质在不同b值下ADC值及SI值差异;绘制不同b值的ROC曲线,分析ADC、SI值鉴别诊断良、恶性肿瘤的效能以及最优b值。结果 b值为300、500、800 s/mm~2时,良性肿瘤组ADC值[(1.80±0.30)×10~(-3)、(1.60±0.26)×10~(-3)、(1.40±0.23)×10~(-3)mm~2/s]高于恶性肿瘤组[(1.50±0.18)×10~(-3)、(1.32±0.18)×10~(-3)、(1.11±0.20)×10~(-3)mm~2/s](P均<0.05),SI值(391.31±77.11、291.34±77.47、202.38±69.21)与恶性肿瘤组(431.23±79.64、313.57±77.70、223.31±68.74)比较差异均无统计学意义(P>0.05);ROC曲线分析结果显示,b值为300、500、800 s/mm~2时的AUC分别为0.785,0.794、0.819,且b值为800 s/mm~2时ADC值的鉴别诊断效能最大,鉴别良、恶性肺部肿瘤的截断值为1.37×10~(-3)mm~2/s,敏感性为68.8%,特异性为88.2%。结论多b值DWI检査可用于肺部肿瘤良、恶性质的鉴别诊断,b值为800 s/mm~2时ADC值诊断肺部肿瘤的准确性较高。
Objective To investigate the difference of apparent diffusion coefficient (ADC) and DWI signal intensity (DWI) at different b-values in patients with benign and malignant lung tumors, The value of differential diagnosis of benign and malignant lung tumors. Methods Fifty patients with lung cancer, including 34 cases of malignant tumor (malignant tumor group) and 16 cases of benign tumor (benign tumor group), were examined by MRI and b value before surgery (b values were 300, 500, 800 s / mm ~ 2) DWI was performed to compare the difference of ADC value and SI value between different b values in two groups of lung lesions; the ROC curves of different b values were plotted and the ADC and SI values were analyzed for the differential diagnosis of benign and malignant tumors Performance and optimal b value. Results When the b value was 300, 500, 800 s / mm ~ 2, the ADC value in the benign tumor group was (1.80 ± 0.30) × 10 ~ (-3), (1.60 ± 0.26) × 10 ~ (-3) (1.50 ± 0.18) × 10 ~ (-3), (1.32 ± 0.18) × 10 ~ (-3), (1.11 ± 0.18) × 10 ~ (-3) (P <0.05), SI value (391.31 ± 77.11, 291.34 ± 77.47, 202.38 ± 69.21) and malignant tumor group (431.23 ± 79.64, 313.57 ± 77.70 , 223.31 ± 68.74) (P> 0.05). The ROC curve analysis showed that the AUC of b value of 300, 500 and 800 s / mm ~ 2 were 0.785, 0.794 and 0.819 respectively, and b The ADC value of 800 s / mm ~ 2 was the most effective in differential diagnosis. The cutoff value of differentiated benign and malignant lung tumors was 1.37 × 10 -3 mm 2 / s and the sensitivity was 68.8%. The specificity 88.2%. Conclusions Multi-b value DWI can be used to diagnose benign and malignant lung tumors. ADC value of 800 s / mm ~ 2 is of high accuracy in diagnosing pulmonary tumors.