胸部DWI技术及其在肺癌N分期中的临床应用

摘要

Diffusion-weighted imaging(DWI)is a noninvasive and functional magnetic resonance imaging technique that reflects the random thermal motions of water molecules.It shows good clinical significance in the diagnosis and differen-tial diagnosis of tumors.Due to the anatomical limitations,it was difficult of magnetic resonance imaging for the chest. Recently,the hardware and software facilities of magnetic resonance have developed rapidly,with the application of stronger gradient and coil,rapid imaging sequence,fat suppression and respiratory gating technology,the image quality of chest DWI has been greatly improved.Many studies have demonstrated that DWI can be used for the diagnosis,staging and assessment of treatment response of lung cancer.The sensitivity and specificity of DWI in hilar and mediastinal lymph nodes of lung cancer are comparable with those of positron emission tomography /CT.It shows significant clinical value in the diagnosis and differential diagnosis of benign and malignant lymph nodes,which suggests that DWI can be used as an important means in N staging of lung cancer.%扩散加权成像(DWI)是反映水分子随机热运动的无创性的磁共振功能成像技术,在肿瘤的诊断及鉴别中显示出较好的临床价值.胸部由于自身解剖限制,曾是磁共振检查的难点.近年来,磁共振软硬件设施有了快速发展,随着更强的梯度及线圈、快速成像序列、脂肪抑制技术及呼吸门控技术等的应用,胸部DWI图像质量有了很大提高.DWI在肺癌诊断、分期及疗效评估中的应用备受关注,在肺癌肺门纵隔淋巴结中的敏感性和特异性与正电子发射断层成像/CT相当,在淋巴结良恶性的诊断及鉴别诊断中显示出重要的临床价值,可作为诊断肺癌肺门纵隔淋巴结转移的重要手段.