【摘要】 目的扩散加权成像(DWI)在肺部病变良恶性鉴别、肺癌与肺不张的区分等方面展现出较高的临床应用价值。文中探讨不同b值DWI-ADC在肺癌与阻塞性肺病变鉴别中的应用及诊断效能。方法回顾性分析2019年1月至2020年12月江苏省肿瘤医院收治49例肺癌合并阻塞性肺病变患者多b值DWI序列检测结果,统计分析不同b值下ADC值差异,探讨不同b值对ADC值测量的影响,并进一步分析不同b值下DWI对区别肺癌与阻塞性肺病变的诊断价值。结果入组患者多b值ADC测量结果间差异均有统计学意义(P<0.05)。肺癌病灶及阻塞性肺病变ADC值与b值之间存在弱相关关系(r=-0.59、r=-0.51)。b值分别设定为200、500、800、1000、1200 s/mm~2时,ADC值诊断肺癌与阻塞性肺病变ROC曲线下面积依次为0.841 1、0.90、0.943 1、0.944 4和0.929 0,其中b=200 s/mm~2时最低(P<0.05)。结论肺部DWI成像b值选择500～1200 s/mm~2时均可获得较好的诊断效果及图像质量。其中尤以800～1000 s/mm~2诊断效能最佳。更多还原

【Abstract】 Objective DWI has high clinical value in differentiation of benign and malignant lung lesions, lung cancer and atelectasis. In the study, the application and diagnostic ability of different b-value DWI/ADC in distinguishing lung cancer from obstructive pulmonary disease was investigated. Methods This retrospective study included 49 patients with lung cancer complicated with obstructive pulmonary disease from Jiangsu cancer Hospital, examined their multiple b-value DWI sequence, and analyzed the differences in ADC values under different b values. This study also aims to explore the effect of different b values on the measurement of ADC values and further analyze the diagnostic performance of different b-values DWI to distinguish lung cancer from obstructive pulmonary disease. Results Statistical difference in multiple b values ADC measurement was found(P<0.05). Weak negative correlation between ADC values and b values in lung cancer and obstructive pulmonary disease was observed. When the b-value was set to be 200, 500, 800, 1000 and 1200 s/mm~2, the areas under the ROC curve(AUC) of ADC values were 0.841 1, 0.90, 0.943 1, 0.944 4, 0.929 0 respectively, with the minimum area of 0.8411 in b-value of 200. Conclusion The better diagnostic results and image quality can be obtained when the b value of pulmonary DWI imaging ranges from 500-1200 s/mm~2, and the best diagnostic performance can achieve between 800 and 1000 s/mm~2.更多还原