肺结节影像检查及诊断.ppt

肺隔离症 M:53Y，咳嗽，痰中带血半月 动态MRI 慢性炎症 高、中分化腺癌 变形严重 参数 恶性肿瘤(10-3) 良性病变(10-3) P值 Standard ADC 1.22±0.48271*10-3 1.42±0. 42*10-3 0.0282 * Slow ADC_mono 1.228±0.484*10-3 1.266±0.35*10-3 0.0345 * Fast ADC_mono 1.23±0.93*10-2 0.81±0.57*10-2 0.0063 * Fraction of fast ADC_mono 0.32±0.21 0.49±0.25 0.0004 * Slow ADC_bi 1.15±0.90*10-3 0.99±1.09*10-3 0.0392 * Fast ADC_bi 7.42±5.15*10-2 7.74±5.88*10-2 0.8741 Fraction of fast ADC_bi 0.31±0.18 0.40±0.20 0.0373 * （注：ADC值单位为mm2/s，标*为有显著性差异） 肺良恶性肿瘤多b值（双指数模型）统计结果（37例） 病例数 26 11 各种肺结节DCE-MRI统计结果 筛查 检查 定性 小 结 MRI PET/CT CT 谢 谢！ * Most of the incidentally detected pulmonary nodules remain indeterminate at imaging and are non calcified.They represent a common finding on CT scans with a prevalence ranging between 8 and 51 %, depending on the study considered.They are frequently more than one, with a diameter less than 10 millimeters in 96% of the cases.Among these 72%of cases are even less than 5 mm in diameter.This demonstrates that small incidental indeterminate nodules are our major concern.However, their malignancy rate is relatively low, ranging between 1 and 12% according to different studies. Indeed, pulmonary nodules may have different appearances.They may be solid appearance or subsolid, a category separate from the solid ones for a management perspective.Subsolid nodules may be pure ground glass nodules or part-solid ground glass nodules, containing both solid and ground glass components. Different prevalence of malignancy has been reported according to different nodule density, with the highest one for part-solid nodules, 63%, followed by pure GG nodules with 18% and then by solid nodules with only 7%. * * As regards calcifications, it is well known that the distribution and morphology of calcifications may be helpful in differential diagnosis of pulmonary nodule; indeed diffuse, central or laminated as well as pop-corn like calcifications are associated to benign lesi