目的:研究不同病理类型肺癌磁共振表观扩散系数差异,并采取高b值评价肿瘤内部特征.方法:经临床手术病理证实的72例肺癌患者,行MRI T1 WI、T2 WI、T2压脂和DWI扫描(b值为0、500、1 000、2 000s/mm2);对不同b值所算出的ADC图上的病灶进行测量,利用方差分析比较其差异.对b值为2000的ADC值进行分析,比较b值为1 000的ADC值,以t检验和方差分析进行比较.结果:本组70例肺癌显示高信号,2例小细胞癌未显示明显高信号,随b值增加,DWI信号强度增大.不同b值,平均ADC值均随b值增加而逐渐变小,差异有统计学意义.不同类型肺癌ADC值有差异.结论:不同病理组织类型的肺癌其ADC值不同,b值为1 000s/mm2和高b值(b=2 000s/mm2)时,平均ADC值均有价值,对于分化良好的腺癌,高b值(b=2 000s/mm2)时鉴别诊断更有价值,并且对良恶性肿瘤鉴别及恶性程度高低有一定价值.%Objective:To study the apparent diffusion coefficient differences in different pathological types of magnetic resonance for lung cancer and adopt high b value to evaluate the characteristics of tumor.Methods:72 cases of lung cancer,who were confirmed by clinical surgery pathology,were performed MRI T1WI,T2WI,T2 fat and DWI scan (b value were 0,500,1 000,2 000s/mm2).Lesions of ADC were measured according to differenrt b values using analysis of variance to compare their differences.Analyzing the ADC values when b value was 2 000,and comparing with ADC values when b value was 1 000,by t test and variance analysis.Results:70 cases lung cancer showed high signal,2 cases of small cell carcinoma did not show high signal obviously,with the b value increasing,the DWI signal strength could increase.With different b values,the average ADC values were gradually decreased with the increase of b value,the difference was statistically significant.There were differences in different types of lung cancer ADC values.Conclusion:With different histopathologic types of lung cancer,the ADC values were different.When b value was 1 000s/mm2 and high value (b =2 000s/mm2),the average ADC values were valuable.For well-differentiated adenocarcinomas,high b value (b =2 000s/mm2) was more valuable in the differential diagnosis,and had a certain value to identify benign and malignant tumor and malignant level.
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