摘要
目的探讨多b值扩散加权成像(DWI)参数在鉴别肺肿块良恶性中的价值。方法 38位患者行常规序列和DWI序列扫描,DWI采用呼吸触发单次激发平面回波成像联合并行采集技术,分别选取9个b值(0、50、100、150、200、400、600、1000、1500 s/mm2)。利用体素内不相干运动模型评估组织中纯扩散系数(D值)、灌注相关扩散系数(D*值)和灌注分数(f值),采用Mann-Whitney U检验比较恶性组与良性组相关参数值的差异,受试者工作特征(ROC)曲线评价各参数的诊断效能。结果 38例患者中,30例经病理证实,8例经临床资料证实;肺恶性组23例,良性组15例。肺恶性组D值明显低于良性组(Z=3.308,P=0.001),两组间D*(Z=1.646,P=0.100)和f值(Z=1.254,P=0.210)差异没有显著意义。D值的ROC曲线下面积(0.839)最大,当D选择阈值为0.90×10-3mm2/s时,诊断恶性病变的敏感性为95.7%,特异性为80.0%,准确性为90.9%,阳性预测值为91.7%,阴性预测值为88.9%。结论多b值DWI参数中D值对于鉴别肺肿块的良恶性有显著意义,诊断效能最大。
Objective To explore the value of multiple b-value diffusion-weighted imaging （DWI） for differentiation of benign and malignant pulmonary masses. Methods tine sequences and DWI pulse sequence. DWI was acquired through Thirty-eight patients were examined by rou- a single-shot echo-planar imaging combined with a respiratory-triggered mode and parallel acquisition. Nine b values ranging from 0 to 1500 s/mm2 （0, 50, 100, 150, 200, 400, 600, 1000, 1500 s/mm2） were used. The intravoxel incoherent motion model was ap- plied to estimate pure diffusion coefficient D, perfusion-related diffusion coefficient D ＊, and perfusion fraction f. Mann-Whitney U test was used to compare all measured parameters between benign and malignant groups. The diagnostic performance of the related parameters was evaluated with receiver operating characteristics （ROC） a- nalysis. Results Of these 38 patients, 30 were pathologically confirmed and 8 were diagnozed based on clinical data. There were 23 lung malignant masses and 15 benign lesions. A significant reduction of D was found in ma- lignant group than in benign group （ Z = 3. 308, P = 0. 001 ）, while no significant differences in D＊ （ Z = 1. 646, P =0. 100） andf （Z = 1. 254, P =0. 210） were observed between the two groups. The area under the ROC curve for D value （0. 839） was largest. When the cutoff value was selected as 0. 90 ×10^-3 mm^2/s, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of diagnosing malig- nant masses were 95.7%, 80.0%, 90. 9%, 91.7%, and 88.9%, respectively. Conclusion The D value in multiple b-value DWI has certain significance in differentiating the benign and malignant pulmonary masses and has the best diagnostic efficiency.
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2014年第5期510-515,共6页
Acta Academiae Medicinae Sinicae
关键词
肺部
良恶性肿块
扩散加权成像
体素内不相干运动
lung, benign and malignant masses
diffusion weighted imaging
intravoxel incoherent motion
