Use of diffusion-weighted magnetic resonance imaging to distinguish between lung cancer and focal inflammatory lesions: a comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient
Use of diffusion-weighted magnetic resonance imaging to distinguish between lung cancer and focal inflammatory lesions: a comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient
复制标题
使用扩散加权磁共振成像区分肺癌和局灶性炎症病变：体素内不相干运动导出参数和表观扩散系数的比较
DOI：
10.1177/0284185115586091
复制
发表时间：
2016-11-01
期刊：
影响因子：
1.3
通讯作者：
Liu, Zaiyi
中科院分区：
文献类型：
--
作者：
Deng, Yu;Li, Xinchun;Liu, Zaiyi
背景
利用影像学技术诊断肺部恶性和炎性病变可能具有挑战性。
目的
比较体素内不相干运动（IVIM）和表观扩散系数（ADC）磁共振成像（MRI）分析在区分肺癌与局灶性炎性肺部病变方面的能力。
材料与方法
纳入38例肺部肿块患者：30例肺癌和8例炎性病变。患者使用3.0T MRI扩散加权成像（DWI）进行成像，采用10个b值（范围，0 - 1000 s/mm²）。使用分段双指数分析计算组织扩散率（D）、伪扩散系数（D*）和灌注分数（f）。通过对DWI数据进行单指数拟合计算ADC（总和）。比较肺癌和炎性肺部病变之间的D、D*、f和ADC。对所有DWI参数进行受试者工作特征分析。
结果
炎性病变的ADC显著高于肺癌（[1.21±0.20]×10⁻³ mm²/s对比[0.97±0.15]×10⁻³ mm²/s；P = 0.004）。通过IVIM发现，炎性病变中的f显著高于肺癌（[46.10±12.92]%对比[29.29±10.89]%；P = 0.005）。肺癌和炎性病变之间的D和D*无差异（分别为P = 0.747和P = 0.124）。f在区分肺癌和炎性肺部病变方面与ADC具有相当的诊断效能，曲线下面积分别为0.833和0.826，敏感度分别为80.0%和73.3%，特异度分别为75.0%和87.5%。
结论
IVIM参数f值与ADC具有相当的诊断效能，可作为区分肺癌与炎性病变的替代标志物。
Background Using imaging techniques to diagnose malignant and inflammatory lesions in the lung can be challenging. Purpose To compare intravoxel incoherent motion (IVIM) and apparent diffusion coefficient (ADC) magnetic resonance imaging (MRI) analysis in their ability to discriminate lung cancer from focal inflammatory lung lesions. Material and Methods Thirty-eight patients with lung masses were included: 30 lung cancers and eight inflammatory lesions. Patients were imaged with 3.0T MRI diffusion weighted imaging (DWI) using 10 b values (range, 0–1000 s/mm2). Tissue diffusivity (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were calculated using segmented biexponential analysis. ADC (total) was calculated with monoexponential fitting of the DWI data. D, D*, f, and ADC were compared between lung cancer and inflammatory lung lesions. Receiver operating characteristic analysis was performed for all DWI parameters. Results The ADC was significantly higher for inflammatory lesions than for lung cancer ([1.21 ± 0.20] × 10−3 mm2/s vs. [0.97 ± 0.15] × 10−3 mm2/s; P = 0.004). By IVIM, f was found to be significantly higher in inflammatory lesions than lung cancer ([46.10 ± 12.92] % vs. [29.29 ± 10.89] %; P = 0.005). There was no difference in D and D* between lung cancer and inflammatory lesions (P = 0.747 and 0.124, respectively). f showed comparable diagnostic performance with ADC in differentiating lung cancer from inflammatory lung lesions, with areas under the curve of 0.833 and 0.826, sensitivity 80.0% and 73.3%, and specificity 75.0% and 87.5%, respectively. Conclusion The IVIM parameter f value provides comparable diagnostic performance with ADC and could be used as a surrogate marker for differentiating lung cancer from inflammatory lesions.