Department of Radiology, General Hospital of Tianjin Medical University, Tianjin, China.
Eur Radiol. 2010 Apr;20(4):807-15. doi: 10.1007/s00330-009-1629-6. Epub 2009 Oct 28.
The role of diffusion-weighted MR imaging (DWI) in the differential diagnosis of pulmonary malignant tumours and solid benign lesions was investigated.
Sixty-two patients with 66 lesions underwent conventional MRI and DWI (diffusion factor of 0 and 500 s/mm(2)) examinations with 1.5-T MRI. The signal intensity of DWI images was observed and the apparent diffusion coefficient (ADC) values of the lesions were measured. Statistical analyses were performed with the independent samples t test, Pearson's chi-square test and receiver operating characteristic (ROC) analysis.
The signal intensities of pulmonary malignant tumours and solid benign lesions were not significantly different, but the ADC value of benign lesions was statistically higher than that of malignant tumours (p = 0.001). By ROC analysis, the optimal threshold of ADC was 1.400 x 10(-3) mm(2)/s and the sensitivity and specificity were 83.3% and 74.1%, respectively. There were statistical differences between small cell carcinoma (SCLC) and non-small cell carcinoma (NSCLC) as well; the former was lower than the latter (p = 0.007).
Our data indicate that quantitative analysis of ADC values may help diagnose or distinguish pulmonary lesions, and it also provides a promising method for characterising the pulmonary masses.
探讨弥散加权磁共振成像（DWI）在肺恶性肿瘤与实性良性病变鉴别诊断中的作用。
62 例 66 个病灶患者均行 1.5T MRI 常规平扫及 DWI（弥散系数分别为 0 和 500 s/mm2）检查，观察 DWI 图像信号强度并测量病灶表观弥散系数（ADC）值。采用独立样本 t 检验、Pearson χ2 检验及受试者工作特征（ROC）曲线分析对数据进行统计学分析。
肺恶性肿瘤与实性良性病变的信号强度无明显差异，但良性病变的 ADC 值明显高于恶性肿瘤（p = 0.001）。通过 ROC 分析，ADC 值的最佳诊断阈值为 1.400 x 10(-3) mm(2)/s，敏感度和特异度分别为 83.3%和 74.1%。小细胞肺癌（SCLC）与非小细胞肺癌（NSCLC）之间亦存在统计学差异，前者低于后者（p = 0.007）。
定量分析 ADC 值有助于诊断或鉴别肺内病变，为肺部肿块的定性提供了一种有前景的方法。
