Zhao Chunli, Deng Dong, Ye Wei, Long Liling, Lu Yumin, Wei Youyong
Department of Radiology, People's Hospital of Guangxi Zhuang Autonomous Region Nanning, China.
Department of Radiology, The First Affiliated Hospital of Guangxi Medical University Nanning, China.
Am J Transl Res. 2021 Jan 15;13(1):88-101. eCollection 2021.
This study aimed to determine applicable value of DWIBS in diagnosis of solitary pulmonary lesions. This study involved 32 solitary lung disease patients. T1W1, T2W1, T2WI-SPAIR were examined using MRI scanner and analyzed with View-forum 6.0 workstation. Imaging characteristics of pulmonary solitary lesions on DWIBS and ADC when b=300, 500 and 800 s/mm were observed. Signal-to-noise ratio (SNR), contrast-noise-ratio (CNR) and ADC value of lesions under different b-values were measured. Image quality in different b-values was compared by analyzing SNR and CNR. ADC values of benign and malignant lesions in different b-value groups were tested using -test. ROC curve was used to evaluate diagnostic efficacy of ADC value, and obtain diagnostic threshold. The results indicated that SNR and CNR value of 300 and 500 s/mm group was significantly higher compared to 800 s/mm group (<0.05). When b-value was assigned as 500 s/mm, DWIBS demonstrated better and ideal images. ADC value of malignant lesions in different b-values was significantly lower compared to benign lesions (<0.05), suggesting ADC value is a feasible approach for distinguishing benign from malignant lesions. AUC value of b=500 s/mm was significantly higher compared to b=300 and b=800 s/mm group (<0.05). When b-value was assigned as 500 s/mm, the best ADC threshold value was 1.435×10 mm/s, with high sensitivity, specificity and accuracy of 80.0%, 83.3% and 84.4%, respectively. In conclusion, quantitative analysis of DWIBS examination and ADC value was helpful for qualitative diagnosis of pulmonary solitary lesions, and demonstrated potential to distinguish benign and malignant pulmonary solitary lesions.
本研究旨在确定弥散加权体部成像（DWIBS）在孤立性肺病变诊断中的应用价值。本研究纳入了32例孤立性肺疾病患者。使用MRI扫描仪对其进行T1加权成像（T1WI）、T2加权成像（T2WI）、T2加权脂肪抑制成像（T2WI-SPAIR）检查，并通过View-forum 6.0工作站进行分析。观察b值为300、500和800 s/mm²时，DWIBS及表观扩散系数（ADC）图上肺内孤立性病变的影像特征。测量不同b值下病变的信噪比（SNR）、对比噪声比（CNR）及ADC值。通过分析SNR和CNR比较不同b值下的图像质量。采用t检验比较不同b值组中良恶性病变的ADC值。绘制ROC曲线评估ADC值的诊断效能，并获得诊断阈值。结果显示，300和500 s/mm²组的SNR和CNR值显著高于800 s/mm²组（P<0.05）。当b值设定为500 s/mm²时，DWIBS显示出更好的理想图像。不同b值下恶性病变的ADC值显著低于良性病变（P<0.05），提示ADC值是鉴别良恶性病变的可行方法。b=500 s/mm²组的曲线下面积（AUC）值显著高于b=300和b=800 s/mm²组（P<0.05）。当b值设定为500 s/mm²时，最佳ADC阈值为1.435×10⁻³mm²/s，其敏感度、特异度及准确度分别为80.0%、83.3%和84.4%。综上所述，DWIBS检查及ADC值的定量分析有助于孤立性肺病变的定性诊断，且在鉴别肺内孤立性病变的良恶性方面具有一定潜力。
