对比增强SWI对不同病理类型肺癌脑转移瘤的诊断价值
The value of contrast-enhanced SWI on brain metastases of different pathological types of lung cancer
吴立业 1罗文明 1蒋锡丽 1黄子龙 1刘军2
作者信息
- 1. 410007 长沙,湖南省脑科医院(湖南省第二人民医院)放射科
- 2. 410011 长沙,中南大学湘雅二医院放射科
- 折叠
摘要
目的:探讨对比增强磁敏感加权成像(CE-SWI)与常规对比增强 T1 WI 成像(CE-T1 WI)对不同病理类型肺癌脑转移瘤的检出率差异,分析脑转移瘤内出现对比剂诱导相移(CIPS)与原发性肺癌病理类型间的关联性.方法:搜集经病理证实的 79 例原发性肺癌患者,其中腺癌组 40 例,鳞癌组 18例,小细胞癌组 21 例,均行颅脑 MR 常规平扫、SWI、CE-T1 WI 及 CE-SWI 检查,比较 CE-SWI 与 CE-T1 WI检出的脑转移瘤数目及转移瘤内是否存在 CIPS,转移灶经 3 个月后随访证实.结果:CE-T1 WI与CE-SWI对腺癌脑转移瘤的检出率差异有统计学意义(χ2＝5.05,P＝0.025),对鳞癌(χ2＝0.00,P＝1.000)与小细胞癌(χ2＝0.27,P＝0.603)脑转移瘤的检出率差异无统计学意义.腺癌组、鳞癌组、小细胞癌组三组间CIPS阳性率差异有统计学意义(χ2＝11.13,P＝0.004),其中鳞癌组与腺癌组(χ2＝11.08,P＝0.001)、鳞癌组与小细胞癌组(χ2＝8.26,P＝0.004)间差异有统计学意义,腺癌组与小细胞癌组间差异无统计学意义(χ2＝0.131,P＝0.717).结论:CE-SWI 对肺腺癌脑转移瘤的检出较 CE-T1 WI更有优势.肺腺癌、小细胞癌脑转移瘤的 CIPS 阳性率较鳞癌显著增高,CE-SWI 可为肺癌脑转移瘤MRI检查常规序列的有利补充,为临床诊疗提供更多重要参考信息.
Abstract
Objective:To evaluate the difference between contrast-enhanced susceptibility weigh-ted imaging(CE-SWI)and conventional contrast-enhanced T1 weighted imaging(CE-T1 WI)in the detection rate of brain metastases from different pathological types of lung cancer,and to study the correlation between contrast-induced phase shifts(CIPS)in brain metastases and pathological types of primary lung cancer.Methods:Seventy-nine patients with primary lung cancer confirmed by pathology were included,including 40 cases with adenocarcinoma,18 cases with squamous cell carcinoma and 21 cases with small cell carcinoma.All patients underwent MRI scan which included plain T1 WI and SWI,CE-T1 WI,and CE-SWI.The number of brain metastases detected by CE-SWI and CE-T1 WI and the presence of CIPS in each metastatic tumor were recorded and compared between groups.The metastat-ic tumors were confirmed by follow-up after 3 months.Results:The CE-T1 WI and CE-SWI detection rate of adenocarcinoma brain metastases was significantly different(χ2＝5.05,P＝0.025).No signifi-cant difference was found in the detection rate in squamous cell carcinoma group(χ2＝0.00,P＝1.000)and small cell carcinoma group(χ2＝0.27,P＝0.603).The positive rate of CIPS among the three groups was significantly different(χ2＝11.13,P＝0.004).Furthermore,there was significant difference between the squamous cell carcinoma group and the adenocarcinoma group(χ2＝11.08,P＝0.001)and between the squamous cell carcinoma group and small cell carcinoma group(χ2＝8.26,P＝0.004).However,there was no significant difference between the adenocarcinoma group and the small cell car-cinoma group(χ2＝0.131,P＝0.717).Conclusion:CE-SWI is superior to CE-T1 WI in detecting brain metastases of lung adenocarcinoma.The positive rate of CIPS in brain metastases of lung adenocarcino-ma and small cell carcinoma was significantly higher than that of squamous cell carcinoma.CE-SWI can be a beneficial supplement to the routine MRI sequences to detect brain metastases of lung cancer,and can provide more important reference value for clinical diagnosis and treatment.
关键词
肺肿瘤/脑转移瘤/磁敏感加权成像/磁共振成像/对比剂诱导相移Key words
Lung tumors/Brain metastases/Susceptibility weighted imaging/Magnetic reso-nance imaging/Contrast induced phase shift引用本文复制引用
基金项目
湖南省科技厅临床医疗技术创新引导项目(2020SK50805)
出版年
2024
NETL
NSTL
维普
万方数据