| Part? The application of 3.0T MRI with conventional pulse sequences in lung cancerObjective: To evaluate the image quality and clinical application of the routine pulse sequences of 3.0T high field magnetic resonance(MR)in lung cancer.Materials and Methods: First is to scan 43 cases of lung cancer patient in conventional pulse sequences from 2015.09 to 2016.05.Among the 43 patients,24 are males and 19 are females.The average age was 60,in range of 42-77.The dimension range of the lesion was 20–93 mm.MR images were obtained using a 3.0-Tesla Siemens Skyra superconductive MRI system.Scan sequences were as followed: axial:T2WI/TSE-BLADE ? DWI/EPI ?T1WI/VIBE-DIXON,coronal and axial:T2WI/HASTE-bh.T2WI/TSE-BLADE sequence adopted breath heart switch control techniques.Diffusion-weighted imaging was performed using b-values of 0,600s/mm2.The following step is to analyze the motion artifact,bronchia,difference of lung lesions and secondary atelectasis of the different scanning sequence images.Then analysis the signal characteristic of lung lesions among each sequence.SAS 9.3 statistical software was used for analysis.And P<0.05 was thought to be statistically significant.The difference of motion artifact among each sequence were compared with Kruskal-Wallis H test.Distinguishing the differences between lung tumor and secondary atelectasis were compared with Fisher exact test.Bonferroni method is used for revising the P value of the pairwise comparison results.Results: 1.There was statistically difference of the motion artifacts among the four secquence images(?2=25.4906,P=0.0001).The motion artifacts from respiration and pulsation on the HASTE images were better controlled than other three sequences,The motion artifacts appeared at a rate of 2%(1/43).The rate of moderate motion artifact respectively accounted for 44.2%(19/43)?11.6%(5/43)in the TSE-BLADE-T2 andEPI-DWI sequence images.Serious artifacts appeared in one case in the VIBE-T1 sequence.Statistically difference appeared among the TSE-BLADE-T2 ?HASTE-T2 and EPI-DWI sequence(Z=4.5618,P<0.0001,Pj<0.0001;Z=3.3405,P=0.0008,Pj=0.005).There was statistically difference between the HASTE-T2 and VIBE-T1 sequence(Z=-3.0912,P=0.0019,Pj=0.012).2.Bronchia showed best in the TSE-BLADE sequence;All TSE-BLADE-T2 group can show the bronchioles,and tube wall was smooth,The rate of the level 1 imaging was 100%;but tube walls were vague in the other secquences imagings,even bronchus can't display.3.Secondary obstructive atelectasis orpneumonia appeared in 11 patients of 43 cases.TSE-BLADE-T2,HASTE-T2 and EPI-DWI can distinguish neoplastic foci and secondary atelectasis,identification rate were 72.7%,81.8%,81.8%.In fact,there was no statistically significant difference between each other(table probability were 0.3446,0.3446,0.3446,p = 1.0000).VIBE-T1 sequence failed to distinguish them.4.High signal appeared in 97.6 percent of the lesion in T2 WI.There was equal signal in one case.The average rate of lesions signal to skeletal muscle was 2.8(range:1.5-4.8);equal signal appeared in 65.1 percent of the lesion in T1 WI.Slightly low signal appeared in 8 cases.Slightly high signal appeared in 7 cases.The average rate of lesions signal to skeletal muscle was 1.0(range:0.7-1.4);The lesions were high signal in DWI,The signals reduced in ADC maps.The average rate of lesions signal to spinal cord was 1.1(range:0.6-2.2);the mean ADC were 1.050 x10-3mm2/s for lung tumors.Conclusions: 3.0 T MR conventional pulse sequence(T2WI/TSE-BLAD ? DWI/EPI ?T1WI/VIBE-DIXON?T2WI/HASTE-bh)images respectively have their advantages and disadvantages,they can complement each other in application,and also play its unique advantages in the chest imaging.TSE-BLADE-T2?HASTE-T2 and EPI-DWI have certain clinical value to distinguishlung tumor and secondary atelectasis.Lesions were mostly high signal on T2 WI,equal signal on T1 WI,high signal on DWI,Signal intensity decreases on ADC map.Part? Research on the characteristics change of lung cancer pre-and post-chemotherapy by MRI diffusion weighted-imaging based intravoxel incoherent motionObjective: To discuss the characteristics of ADC?D?PF?D* and DWI LSR values change of lung cancers before and after chemotherapy by MRI diffusion weighted-imaging based intravoxel incoherent motion.Materials and Methods: 27 patients were evaluated prospectively.In 27 patients,16 cases was male,11 cases.11 cases was female.The median age was 54,and the range is 36-78.The median dimension of the lesion was 50mm(range: 22–86 mm).MR images were obtained using a 3.0-Tesla Siemens Skyra superconductive MRI System.Diffusion-weighted imaging was performed by using b-values of 0,10,20,30,40,50,100,200,400,600,800 and 1000(s/mm2).The following IVIM parameters were calculated: apparent diffusion coefficient(ADC),true diffusioncoefficient(D),pseudo-diffusion coefficient(D*),and perfusion fraction(PF).MRI was performed within one week before treatment and at 3 weeks after beginning treatment.CT was performed within one week before treatment and at 6 weeks after beginning treatment.Tumor response was assessed by CT using modified RECIST.9 cases were in PR group,17 cases were in SD group,PR ?SD were effective treatment groups.1 cases was in PD group.PD was no-responders.PD group did not perform statistical analysis.SPSS 18.0 statistical software was used for above statistical analysis.P<0.05 was thought to be statistically significant.ADC,D,PF,D* and LSR Value of all lesions were respectively compared between pretreatment and posttreatment with paired samples t test.ADC,D,PF,D*and LSR value were compared between PR group and SD group with two independent samples t test.ADC,D values were compared before pretreatment with paired samples t test.Results: 1.The change of ADC? D ?PF?D* value after chemotherapy in lung cancersIn effective treatment group,ADC value was 1.180±0.31,1.291±0.28(10-3mm2/s)before and after chemotherapy,Postreeatment ADC value was higher(t=-3.194,P=0.004),P<0.05,The difference was statistically significant.D value was 1.050±0.35,1.242±0.27(10-3mm2/s)before and after chemotherapy,Postreeatment D value was higher(t=-4.190,P=0.000),P<0.05,The difference was statistically significant.PF value was 16.21±12.16,17.49±12.86(%)before and after chemotherapy,Postreeatment PF value was higher(t=-0.222,P= 0.826),The difference was not statistically significant.D* value was 13.42±6.55,22.38±18.58(10-3mm2/s)before and after chemotherapy,Postreeatment D* value was higher(t=-2.186,P= 0.039),The difference was statistically significant.2.The comparison of ADC?D ?PF and D* between PR group and SD group before chemotherapy Before chemotherapy,ADC value of PR group was 1.210±0.38(10-3mm2/s),D value of PR group was 1.091±0.55(10-3mm2/s),PF value of PR group was 15.56±15.12(%),D* value of PR group was13.1±8.07(10-3mm2/s);ADC value of SD group was 1.170±0.28(10-3mm2/s),D value of SD group was 1.033±0.19(10-3mm2/s),PF value of SD group was 16.56±10.78(%),D* value of SD group was13.58±5.87(10-3mm2/s).ADC value of PR group was higher than that of SD group(t=0.358,P=0.723).The difference was not statistically significant.D value of PR group was higher than that of SD group(t=0.451,P=0.656).The difference was not statistically significant.PF?D* values of PR group were lower than that of SD group,The difference was also not statistically significant.3.The comparison of ADC and D value 27 lesions were measured before chemotherapy.ADC value was 1.180±0.31(10-3mm2/s),D was 1.050±0.35(10-3mm2/s),ADC value was higher than D value(t=3.025,P=0.006),P<0.05.The difference was statistically significant.4.The change characteristics of MRI-DWI LSR value of lung cancers before and afterchemotherapy In effective treatment group,LSR was 1.06±0.43 before chemotherapy,LSR was 0.92±0.35 after chemotherapy,LSR was lower after chemotherapy(t=2.169,P=0.040),P<0.05.The difference was statistically significant.Beforechemotherapy,LSR of PR group was 0.97±0.33,LSR of SD groupwas 1.11±0.47.LSR value of PR group was lower than that of SD group(t=0.765,P=0.452),The difference was not statistically significant.Conclusions: 1.In the effective chemotherapy cases of the lung cancer,both single index model ADC values and double exponential model D value increased after treatment.2.D value was more accurate than ADC value to represent the pure water molecular diffusion movement in lesions.3.The LSR decreased after chemotherapy in the first chemotherapy cycle.4.ADC?D?LSR values may be utilized to evaluate the chemotherapy response of lung cancers.5.In the effective chemotherapy cases of the lung cancer,D* value increased after treatment. |
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