Monoexponential andIVIMmodelofdiffusionweightedimagingin solitarypulmonarynodules-apreli

• 作 者: ShuchangZhou LimingXia
• 机 构: Tongji Hospital,HUST
• 出 处: 中华放射学学术大会2016、中华医学会第23次全国放射学学术大会暨中华医学会第24次全国影像技术学术大会
• 发表日期: 2016年5期
• 关键词: Pulmonary nodules Diffusionweightedimaging monoexponentialmodel IVIM ADC

　　Objective:Toexplore thevalueofMono-exponentialandIVIMmodelofdiffusionweightedimaginginthediagnosisofsolitary pulmonarynodules. Materials and Methods:Atotalof66patientswithSPNunderwentmulti-b-factorDWI(bvaluesof0,20,50,100,150,200,400, 600,and1000s/mm2).Usingthebiexponentialmodelbasedontheintravoxelincoherentmotiontheory(IVIM)tocalculate parametersasfollow:totalADC(standardADC)、slowcomponentapparentdiffusioncoefficient(D),fastcomponentapparent diffusioncoefficient(D*),andfastdiffusionpercentage(F).Comparetheseparametersbetweenbenignandmalignantlesions andbetweendifferentpathologicaltypesoflungcancer.Receiveroperatingcharacteristic(ROC)curvesweregeneratedto evaluatethediagnosticperformanceofeachparameter. Results:StanardADCvaluesofmalignanttumorandbenignitywere1.290(1.440-1.040)×10-3mm2/sand2.000(2.246-1.737) ×10-3mm2/s,respectively.Dvaluesofmalignanttumorandbenignitywere0.988(1.139-0.661)×10-3mm2/sand1.453(1.668-1.054)×10-3mm2/s,respectively.Thesetwoparametersweresignificantlylowerinmalignanttumorcomparedwiththosein benignlesions(p<0.001),D*valuesofmalignanttumorandbenignitywere44.167(87.050-7.385×10-3mm2/s)and7.704(72.375-4.861)×10-3mm2/s,respectively,D*valuesofmalignanttumorwereobviouslyhigherthanthatofbenignlesions(p=0.025)withhighvariability,Fvaluesofmalignanttumor(34.1±16.8%)werelowerthanthatofbenignlesions(51.3±31.8%)(p=0.05),withnoobviouslystatisticaldifferences.Taken1.569×10-3mm2/sand1.250×10-3mm2/sascutoffvaluesofstanard ADCandD,thediagnosticsensitivity,specificityandaccuracywere87.5%,75.0%,83.9%and95.0%,56.3%and84.4%, respectively.ThecombinedapplicationofstandardADCandDcanincreasethediagnosticsensitivity,specificityandaccuraterate to97.4%,75.0%and92.2%.Dvaluesofsquamouscellcarcinomaweresignificantlyhigherthanthatofsmallcellcarcinoma,andD valuesofsquamouscellcarcinomaandadenocarcinomaweresignificantlyhigherthanthatofothertypesofmalignanttumor. Conclusion:Bothmono-exponentialandbi-exponentialmodelDWIbasedonIVIMwasusefulfordifferentiatingbenignand malignantpulmonarynodules,andcanprovidequantitativediffusionandperfusioninformationindependentlybymultiple parameters.StandADCandDwerethemostvaluableparametersandwereabletodifferentiatebenignandmalignantnudules. Dcanreflecttheactualdiffusionoftumormoreaccuratelyandhelptodifferentiatesubtypesoflungcancer.D*haslimited diagnosticvaluebecauseofhighvariability.