扩散加权成像和T2加权成像联合评估可用于肺癌与良性肺结节及肿块的鉴别诊断。

Combination Assessment of Diffusion-Weighted Imaging and T2-Weighted Imaging Is Acceptable for the Differential Diagnosis of Lung Cancer from Benign Pulmonary Nodules and Masses.

作者信息

Usuda Katsuo, Ishikawa Masahito, Iwai Shun, Iijima Yoshihito, Motono Nozomu, Matoba Munetaka, Doai Mariko, Hirata Keiya, Uramoto Hidetaka

机构信息

Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa 920-0293, Japan.

Department of Radiology, Kanazawa Medical University, Ishikawa 920-0293, Japan.

出版信息

Cancers (Basel). 2021 Mar 28;13(7):1551. doi: 10.3390/cancers13071551.

The purpose of this study is to determine whether the combination assessment of DWI and T2-weighted imaging (T2WI) improves the diagnostic ability for differential diagnosis of lung cancer from benign pulmonary nodules and masses (BPNMs). The optimal cut-off value (OCV) for differential diagnosis was set at 1.470 × 10 mm/s for apparent diffusion coefficient (ADC), and at 2.45 for T2 contrast ratio (T2 CR). The ADC (1.24 ± 0.29 × 10 mm/s) of lung cancer was significantly lower than that (1.69 ± 0.58 × 10 mm/s) of BPNM. The T2 CR (2.01 ± 0.52) of lung cancer was significantly lower than that (2.74 ± 1.02) of BPNM. As using the OCV for ADC, the sensitivity was 83.9% (220/262), the specificity 63.4% (33/52), and the accuracy 80.6% (253/314). As using the OCV for T2 CR, the sensitivity was 89.7% (235/262), the specificity 61.5% (32/52), and the accuracy 85.0% (267/314). In 212 PNMs which were judged to be malignant by both DWI and T2WI, 203 PNMs (95.8%) were lung cancers. In 33 PNMs which were judged to be benign by both DWI and T2WI, 23 PNMs (69.7%) were BPNMs. The combined assessment of DWI and T2WI could judge PNMs more precisely and would be acceptable for differential diagnosis of PNMs.

本研究的目的是确定弥散加权成像（DWI）与T2加权成像（T2WI）的联合评估是否能提高肺癌与良性肺结节及肿块（BPNM）鉴别诊断的诊断能力。鉴别诊断的最佳截断值（OCV）设定为表观扩散系数（ADC）为1.470×10⁻³mm²/s，T2对比率（T2 CR）为2.45。肺癌的ADC（1.24±0.29×10⁻³mm²/s）显著低于BPNM的ADC（1.69±0.58×10⁻³mm²/s）。肺癌的T2 CR（2.01±0.52）显著低于BPNM的T2 CR（2.74±1.02）。以ADC的OCV进行判断时，敏感性为83.9%（220/262），特异性为63.4%（33/52），准确性为80.6%（253/314）。以T2 CR的OCV进行判断时，敏感性为89.7%（235/262），特异性为61.5%（32/52），准确性为85.0%（267/314）。在DWI和T2WI均判定为恶性的212个肺结节中，203个（95.8%）为肺癌。在DWI和T2WI均判定为良性的33个肺结节中，23个（69.7%）为BPNM。DWI与T2WI的联合评估能更准确地判断肺结节，可用于肺结节的鉴别诊断。