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 MRI in the differential diagnosis of pulmonary masses in patient with silicosis. Methods 12 cases with silicosis and pulmonary masses were preformed with 1.5T MRI, and the scanning sequences including axialT1WI ,T2WI and SPIR. The primary diagnosis of lesion nature was proposed by the MRI signal and morphology changes of masses. Results MRI results of 12 cases with silicosis and pulmonary masses showed that 9 cases complicated with lung cancer and 3 cases with silicotic fused mass.The coincidence rate was 100% according to the clinical follow up and pathological biopsy. The MRI characteristics of silicotic fused mass were strip-shaped shadow connected with the pleura between the chest wall and mediastinum. The masses showed homogeneous equal signal intensity on T1WI and inhomogeneous equal or low signal intensity on T2WI and SPIR compared to chest wall soft tissue. Masses of lung cancer showed lobulated sign and equal signal intensity on T1WI, high signal intensity on T2WI and SPIR. Of all 9 cases with complicated lung cancer patients, 2 cases complicated with pulmonary atelectasis,and 1 cases with obstructive pneumonia. Conclusion Magnetic resonance imaging is valuable for the differential diagnosis of pulmonary masses in patient with silicosis.