| Objective Through the MRI scan of pulmonary space-occupying lesions,the quantitative parameters of ZOOMit IVIM-DWI and Native T1-mapping were obtained.The results were compared with pathology to explore the role and diagnostic efficacy of the obtained MRI quantitative parameters ADC value,D value,f value and T1 value in differentiating benign and malignant pulmonary space-occupying lesions and different pathological types of lung cancer.Methods Lung MRI was performed on 93 hospitalized patients with newly diagnosed"pulmonary space-occupying lesions" from September 2020 to March 2021.Using Siemens 3T MAGNETOM Prisma scanner and 18-channel body phased matrix coil for scanning,each patient was scanned with the same pre-established MRI sequences and procedure.Finally,76 patients who met the inclusion criteria of this study were selected,and Siemens Syngo.Via workstation was used to analyze and process the ZOOMit IVIM-DWI and Native T1-mapping images of the included examinees.The region of interest was manually outlined along the edge of the lesion at the largest layer of the lesion and the adjacent upper and lower layers,and the ZOOMit IVIM-DWI quantitative parameters ADC value,D value,D*value,f value and T1 value of all subjects were measured.The five quantitative parameters were analyzed statistically using IBM SPSS statistic 25 software.For those parameters with statistical difference,receiver operating characteristic curve was further used to evaluate the diagnostic performance of the parameter.By calculating the area under the curve,according to the principle of the maximum value of Youden index,the results of measuring the diagnostic efficacy such as threshold,sensitivity and specificity were determined.All statistical analysis results were considered statistically significant at P<0.05.Results A total of 76 cases of pulmonary space-occupying lesions were included in this study,including 11 benign lesions(4 cases of hamartoma,1 case of sclerosing pneumocytoma,2 cases of tuberculosis,and 4 cases of chronic granulomatosis),and 65 cases of lung cancer(35 cases of adenocarcinoma,14 cases of squamous cell carcinoma,16 cases of small cell lung cancer).The averages of ADC value,D value,D*value,f value and T1 value in benign group were(1617.84±124.54)×10-6mm2/s,(1451.43±294.38)×10-6mm2/s,(1483.12±679.98)×103mm2/s,(26.65±11.26)%and(1997.45±497.57)ms.The averages of ADC value,D value,D*value,f value and T1 value in lung cancer group were(1110.39±242.06)×10-6mm2/s,(947.98±217.83)×10-6mm2/s,(1309.71±432.55)×10-3mm2/s,(16.26±5.95)%and(1674.12±211.35)ms.The averages of ADC value,D,D*,f and T1 of adenocarcinoma were(1123.86±214.63)×10-6mm2/s,(993.89±180.70)×10-6mm2/s,(1247.61±379.00)×10-3mm2/s,(16.26±5.16)%and(1629.49±190.41)ms.The averages of ADC value,D value,D*value,f value and T1 value of squamous cell carcinoma were(1159.58±265.65)×10-6mm2/s,(897.43±186.04)×10-6mm2/s,(1486.60±504.95)×10-3mm2/s,(20.40±7.55)%and(1765.59±247.87)ms.The averages of ADC value,D value,D*value,f value and T1 value of small cell lung cancer were(1037.89±275.93)×10-6mm2/s,(891.79±296.26)±10-6mm2/s,(1290.78±461.65)×10-3mm2/s,(12.64±3.35)%and(1691.73±205.85)ms.Comparative analysis between the benign group and the lung cancer group showed that the ADC value,D value,f value and T1 value of the benign group were higher than those of the lung cancer group,and the differences were statistically significant(ADC value P<0.001,D value P<0.001,f value P=0.004,T1 value P=0.026).The AUC of the ADC value to distinguish the two groups was 0.9552,the optimal threshold was 1360×10-6mm2/s,the sensitivity was 100%,and the specificity was 87.69%.The AUC of the D value to distinguish the two groups was 0.9483,the optimal threshold was 1116× 10-6mm2/s,the sensitivity was 100%,and the specificity was 81.54%.The AUC of the f value to distinguish the two groups was 0.7769,the optimal threshold was 22.03%,the sensitivity was 63.64%,and the specificity was 84.62%.The AUC of the T1 value to distinguish the two groups was 0.710,the optimal threshold was 1894ms,the sensitivity was 72.73%,and the specificity was 89.23%.The diagnostic efficacy of ADC value was the best because the AUC of the ADC value was the largest,while there was no statistical difference at the D*value between the two groups(P=0.430).Comparative analysis between the non-small cell lung cancer group(adenocarcinoma,squamous cell carcinoma)and the small cell lung cancer group showed that the f value of the non-small cell lung cancer group was higher than that of the small cell lung cancer group,and the difference was statistically significant(P<0.001).The AUC off value to distinguish nonsmall cell lung cancer from small cell lung cancer was 0.7417,the optimal threshold was 14.24%,the sensitivity was 81.25%,and the specificity was 71.43%.However,there was no statistical difference at ADC value,D value,D*value and T1 value between the two groups(ADC value P=0.542;D value P=0.355;D*value P=0.842;T1 value P=0.704).Comparative analysis among the three groups(adenocarcinoma,squamous cell carcinoma,and small cell lung cancer)showed the f value was statistically different among these three groups(P=0.003).The f value of small cell lung cancer was lower than that of squamous cell carcinoma(P=0.002),and there was no statistical difference at the f value between adenocarcinoma and squamous cell carcinoma(P=0.238),the same result was showed between adenocarcinoma and small cell lung cancer(P=0.078).There was also no statistical difference at ADC value,D value,D*value and T1 value among these three groups(ADC value P=0.799;D value P=0.139;D*value P=0.215;T1 value P=0.116).Conclusion As a new MRI scanning technology without contrast enhanced scanning,it had the good application value and clinical prospect to use quantitative parameters ADC value,D value,f value and T1 value of ZOOMit IVIM-DWI and Native T1-mapping imaging in distinguishing benign and malignant pulmonary space-occupying lesions and different pathological types of lung cancer. |
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