Application Value of High Field Dynamic Enhanced MRI Combined with Diffusion Weighted MRI in the Differential Diagnosis of Solitary Pulmonary Nodules in Athletes

Abstract

Objective: To assess the effectiveness of high-field dynamic contrast-enhanced MRI (DCE-MRI) combined with diffusion-weighted MRI (DWI) in distinguishing solitary pulmonary nodules (SPN) in athletes, a group potentially at risk due to their high-performance demands and environmental exposures.

Methods: This retrospective study analyzed data from December 2019 to December 2021, involving 100 athletes diagnosed with SPN at our institution. All subjects underwent high-field DCE-MRI and DWI. The study analyzed quantitative characteristics such as the extravascular space volume ratio (Ve) and the volume transfer constant (Ktrans) from the DCE-MRI, and the apparent diffusion coefficient (ADC) from DWI. Diagnostic metrics including sensitivity, specificity, and area under the receiver operating characteristic curve (ROC AUC) were calculated to assess the utility of combining these MRI techniques.

Results: Of the 100 athlete patients with SPN, 38 were diagnosed with benign nodules and 62 with malignant ones. Significant differences were noted in Ktrans and ADC values between benign and malignant cases, particularly when DWI was conducted with b values between 500 and 700 s/mm^2, enhancing diagnostic precision. The combined approach of high-field DCE-MRI and DWI showed superior diagnostic accuracy (AUC 0.906) compared to DCE-MRI alone, with improved specificity, accuracy, positive predictive value, and negative predictive value.

Conclusion: High-field DCE-MRI combined with DWI is highly effective in the differential diagnosis of SPN in athletes. This diagnostic approach allows for precise and rapid determination of the nature of pulmonary nodules, which is crucial for managing athlete health and optimizing treatment strategies