科研之友
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摘要
Purpose: Imaging plays a critical role not only in detection but also in characterization of pleural thickening as benign or malignant. The aim of the study was to investigate the value of diffusion-weighted (DW) imaging in the differential diagnosis of benign and metastatic malignant pleural thickening. Materials and Methods: Thirty-four patients with 64 pleural foci of nodular thickening (47 metastatic malignant and 17 benign) were included in this prospective study. DW imaging was performed using a breath-hold single-shot spin-echo echo-planar sequence. Two different apparent diffusion coefficient (ADC(1,2)) maps were obtained with different b factors (ADC(1) reconstructed from b factors of 0 and 650 mm(2)/s and ADC(2) reconstructed from b factors of 0 and 1000 mm(2)/s), and ADCs were calculated. Quantitatively, ADCs were compared between the groups, and the optimal cutoff value was found by using receiver operating characteristic curve analysis. Results: Quantitatively, differences in signal intensities on DW trace images with b factors of 650 and 1000 mm(2)/s were not statistically significant. The ADC(1) and ADC(2) of the metastatic malignant thickening were significantly lower than those of benign ones [mean ADC(1) was 1.37 +/- 0.65x10(-3) mm(2)/s for metastatic malignant thickening and 2.11 +/- 0.69x10(-3) mm(2)/s for benign thickening (P=0.045); ADC(2) was 1.06 +/- 0.56x10(-3) mm(2)/s for metastatic malignant thickening and 1.56 +/- 0.71x10(-3) mm(2)/s for benign thickening (P=0.038)]. However, because of the ADC overlap between malignant and benign disease, a sufficiently discriminative cutoff value could not be defined by the receiver operating characteristic curve analysis. Conclusion: Despite fair sensitivity and specificity, DW imaging may serve as a complementary tool that improves the differential diagnosis of pleural thickening.
- 出版日期2016-1
