MR弥散加权成像与HRCT在肺部病变良恶性鉴别中的诊断效能对比

doi:10.3877/cma.j.issn.2095-655X.2024.04.007

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摘要目的探讨磁共振弥散加权成像（DWI）与高分辨率CT（HRCT）在肺部病变良恶性鉴别中的诊断效能。方法回顾性分析2014年 7月至2015年2月广州医科大学附属第一医院胸外科诊治的114例肺部病变患者，均接受胸部HRCT扫描、MR-DWI检查。以HRCT首诊报告结果为参考，将肺部病变分为HRCT明确诊断组与难鉴别组，以术后病理结果为“金标准”，使用受试者操作特征曲线（ROC）评价两者的诊断效能。结果114例患者中，97例（85.09%，97/114）为明确诊断组，DWI和HRCT 的ROC曲线下面积（AUC）分别为0.832(95%CI:0.742～0.900)、0.869(95%CI:0.785~0.969)，两者比较，差异无统计学意义（Z=0.511，P=0.609）。17例（14.91%，17/114）为难鉴别组，两者AUC分别为0.829(95%CI:0.571~0.964)、0.500(95%CI:0.254~0.746)，两者比较，差异有统计学意义（Z=3.077，P=0.002）。结论对于肺部病变，DWI与HRCT具有相当的诊断效能。在HRCT难以鉴别的肺部病变中，DWI能提供额外的诊断价值。

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关键词 ：肺部病变, 弥散加权成像, 高分辨率CT, 诊断, 鉴别, 诊断效能

Abstract：ObjectiveTo explore the diagnostic efficacy of diffusion weighted imaging (DWI) and high resolution CT (HRCT) in differentiating benign and malignant pulmonary lesions. MethodsFrom July 2014 to February 2015, a retrospective analysis was conducted on 114 patients with pulmonary lesions who were treated in the Department of Thoracic Surgery of the First Affiliated Hospital of Guangzhou Medical University. All patients underwent chest HRCT scanning and MR-DWI examination. Based on the initial HRCT report results, the pulmonary lesions were divided into HRCT definitive diagnosis group and indistinguishable group. The postoperative pathological results were used as the "gold standard", and the diagnostic efficacy was evaluated using the receiver operating characteristic (ROC) curve. ResultsAmong the 114 patients, 97 cases (85.09%, 97/114) were in the definitive diagnosis group, the areas under the ROC curve (AUC) of DWI and HRCT were 0.832 (95%CI:0.742-0.900) and 0.869 (95%CI:0.785-0.969), respectively, and the difference was not statistically significant （Z=0.511, P=0.609）. There were 17 cases (14.91%, 17/114) in the indistinguishable group, with AUCs of 0.829 (95%CI:0.571-0.964) and 0.500(95%CI:0.254-0.746), respectively, and the difference was statistically significant （Z=3.077，P=0.002）. ConclusionsDWI and HRCT have comparable diagnostic efficacy. In pulmonary lesions that are difficult to distinguish by HRCT, DWI can provide additional diagnostic value.

Key words： Pulmonary lesions Diffusion weighted imaging High resolution CT Diagnosis, differential Diagnostic performance

收稿日期: 2024-11-01

基金资助:国家自然科学基金青年科学基金项目（81601457）；广东省钟南山基金会（ZNS-XS-ZZ-202409-007）；广州市科技计划项目（2024A03J1229,202201020456）

通讯作者: 万齐， Email: qiwan@gzhmu.edu.cn

引用本文:

黎东城陈涛李新春周嘉璇包盈莹俞家熙万齐. MR弥散加权成像与HRCT在肺部病变良恶性鉴别中的诊断效能对比[J]. 中华诊断学电子杂志, 2024, 12(4): 249-253.
Li Dongcheng, Chen Tao, Li Xinchun, Zhou Jiaxuan, Bao Yingying, Yu Jiaxi, Wan Qi. . Comparative diagnostic efficacy of magnetic resonance diffusion weighted imaging and HRCT in differentiating benign and malignant pulmonary lesions. zhzdx, 2024, 12(4): 249-253.

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