目的：探讨定量动态对比增强MRI（DCE‐MRI）对肺部肿块良、恶性的鉴别诊断价值。方法71例肺部肿块患者（共71个肿块）行DCE‐M RI检查，经病理证实为良性肿块25个（良性组）和恶性肿块46个（恶性组）。测量定量参数容量转移常数（Ktrans ）、速率常数（Kep ）和血管外细胞外间隙容积比（ve ），绘制受试者工作特征曲线，评价各参数值的诊断效能。结果恶性组肿块Ktrans和Kep值均高于良性组肿块[（0.269±0.086） min‐1 vs ．（0.191±0.082） min‐1和（0.937±0.461） min‐1 vs ．（0.573±0.266） min‐1]（P＜0．01）。恶性组肿块ve值与良性组肿块相仿（0.327±0.149 vs ．0.389±0.203）（P＞0．05）。Ktrans 、Kep和ve曲线下面积分别为0.736、0.724和0.403，敏感度分别为87％、41％和85％，特异度分别为52％、96％和20％。结论 DCE‐M RI参数Ktrans 、Kep值有助于鉴别诊断肺部肿块。%Objective To explore the differential diagnosis value of quantitative dynamic contrast enhanced‐MRI(DCE‐MRI) for benign and malignancy of pulmonary lumps .Methods A total of 71 patients with pulmonary lumps (71 lumps ) was examined by DCE‐MRI .On the basis of pathological diagnosis ,71 cases were assigned into two groups of A (with benign lumps ,25 cases) and B(with malignan lumps ,46 cases) .The quantitative parameters of volume transfer constant (Ktrans ) , exchange rate constant (Kep ) and extravascular extracellular volume fraction (ve ) were detected and compared between two groups .Diagnostic performance of parameters was evaluated by drawing receiver operation characteristic curve (ROC) .Results The values of Ktrans and Kep in group B were higher than those in group A[(0.269 ± 0.086) min‐1 vs .(0.191 ± 0.082) min‐1 and (0.937 ± 0.461) min‐1 vs .(0.573 ± 0.266) min‐1 ](P<0 .01) .The value of ve in group B was similar to that in group A (0.327 ± 0.149 vs .0.389 ± 0.203)(P>0 .05) .The areas under the ROC curve of Ktrans ,Kep and ve were 0.736 ,0.724 and 0.403 ,respectively ,with the sensitivities of 87% ,41% and 85% ,and the specificities of 52% ,96% and 20% .Conclusion The dertermination of Ktrans and Kep of DCE‐MRI parameters is helpful in differentiating the benign pulmonary lumps from the malignant .
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