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目的探讨MR成像技术在矽肺合并肺肿块鉴别诊断中的应用价值。方法采用1.5T磁共振成像仪,对12例矽肺合并肺部肿块患者进行扫描成像检查,常规使用横轴位T1WI、T2WI及SPIR回波序列,通过对肿块MRI信号及形态学改变进行分析,对病变性质提出初步诊断。结果12例矽肺肺肿块患者磁共振扫描结果提示,矽肺合并肺癌9例,矽肺融合团块3例。经临床随访和活检定性,符合率达到100%。其矽肺团块磁共振成像特征主要表现为在病灶胸壁和纵隔两侧常可见有较粗大的条索状牵拉影与胸膜相连。团块信号变化与邻近胸壁软组织相比在T1WI相上表现为等信号,整体病灶信号较均匀,在T2WI及SPIR相表现为等低不均匀信号影。矽肺合并肺癌肿块多表现有分叶征,磁共振T1WI为等信号,T2WI及SPIR相为高信号。9例矽肺合并肺癌患者中,2例合并肺不张,1例有阻塞性肺炎。结论磁共振成像检查对矽肺合并肺肿块鉴别诊断具有一定价值。
Objective To explore the value of MR imaging in the differential diagnosis of silicosis complicated with lung mass. Methods Using a 1.5T magnetic resonance imaging system, 12 patients with silicosis complicated with pulmonary masses were examined by scanning imaging. The transverse axial T1WI, T2WI and SPIR echo sequences were used routinely. By analyzing the MRI signals and morphological changes, The nature of the disease proposed a preliminary diagnosis. Results The results of magnetic resonance scanning in 12 patients with silicosis showed that there were 9 silicosis and 3 silicosis. The clinical follow-up and biopsy qualitative, in line with the rate of 100%. The characteristics of its silicosis mass MRI mainly manifested in the chest wall and the mediastinum often visible on both sides of the larger coiled traction shadow attached to the pleura. Compared with the adjacent chest wall soft tissue, the changes of mass signal showed equal signals on the T1WI phase, the signal of the whole lesion was more uniform, and the signals of low and even nonuniformity appeared on T2WI and SPIR. Silicosis complicated with lung cancer showed lobulation, magnetic resonance T1WI is equal signal, T2WI and SPIR phase are high signal. Of the 9 silicosis patients with lung cancer, 2 had atelectasis and 1 had obstructive pneumonia. Conclusion Magnetic resonance imaging has certain value in the differential diagnosis of silicosis with lung mass.