【摘要】 目的 评价MR扩散加权成像（DWI）对实性孤立性肺结节（SPN）的鉴别诊断价值。方法 经手术、活检或临床治疗随访后证实的42例SPN患者，其中恶性25例，良性17例，全部行MR胸部常规T₁WI、T₂WI和DWI检查，b值选择300,500,800 s/mm²和1 000 s/mm²。分别测量不同b值时的表观扩散系数（ADC）值和信号强度。结果 良、恶性SPN的ADC值和信号强度均随b值增加而呈逐渐下降趋势。良、恶性SPN在b值=500 s/mm²时，其ADC值有统计学意义(P₅₀₀=0.03<0.05);而b值在300～1 000 s/mm²时，其信号强度值均有统计学意义(P₃₀₀<0.001,P₅₀₀=0.03<0.05,P₈₀₀=0.01<0.05,P_{1 000}=0.02<0.05)。结论 DWI的信号强度和ADC值对良、恶性SPN鉴别诊断均具有重要临床意义，信号强度值的诊断效能优于ADC值。更多还原

【Abstract】 Objective To evaluate the value of diffusion weighted imaging（DWI） in distinguishing the solid solitary pulmonary nodule（SPN）. Methods 42 patients with SPN（malignant in 25 and benign in 17） who were confirmed by operation, biopsy or follow up after treatment underwent routine chest T₁WI, T₂WI and DWI. The b values were chosen as 300, 500, 800 and 1 000 s/mm², and the corresponding apparent diffusion coefficient（ADC） values and the signal intensity（SI） were respectively measured.Results The ADC values and SI of benign and malignant SPNs were gradually reduced with increasing b value. The ADC value between benign and malignant SPNs was statistically significant with b value of 500 s/mm²(P₅₀₀=0.03<0.05), meanwhile the SI was statistically significant with b values from 300 to 1000 s/mm²(P₃₀₀<0.001, P₅₀₀=0.03<0.05, P₈₀₀=0.01<0.05, P_{1 000}=0.02<0.05).Conclusion Both SI and ADC value of DWI play important role in distinguishing benign and malignant SPNs, and the diagnostic efficiency of SI is superior to ADC value.更多还原