Application value of single-shot excitation fast scanning sequence in the diagnosis of mediastinal and pulmonary hilum masses: A retrospective study

To investigate the application value of the single-shot excitation fast scanning (HASTE) sequence in the diagnosis of mediastinal and pulmonary hilum masses using MRI. This study was a retrospective analysis. Clinical data of 95 patients who underwent MR examination of the mediastinum and pulmonary hilum in our hospital and our hospital's national regional medical center from October 2021 to June 2024 were collected. All patients underwent multi-slice spiral CT enhanced scanning before MR examination, and the sequence used was the HASTE sequence. The imaging characteristics of MR diagnosis of mediastinal and pulmonary hilum masses were analyzed. Using pathological results as the gold standard, the diagnostic performance of multi-slice spiral CT enhanced scanning, MR HASTE sequence, and combined multi-slice spiral CT enhanced scanning with MR HASTE sequence were analyzed and compared. Ninety-five patients were punctured to obtain 95 masses, with a puncture success rate of 100.0 %. Pathological results showed that among the 95 patients, there were 65 cases of malignant lesions and 30 cases of benign lesions. Using pathological results as the gold standard, the sensitivity of MR + MSCT enhanced examination in diagnosing the benign and malignant nature of pulmonary hilum or mediastinal tumors was 87.69 % (57/65), specificity was 86.67 % (26/30), positive predictive value was 93.44 % (57/61), negative predictive value was 76.47 % (26/34), and accuracy was 87.37 % (83/95). The consistency K value with pathological results was 0.718, indicating good consistency between MR + MSCT enhanced examination and pathological diagnosis. The sensitivity of MSCT enhanced scanning in diagnosing the benign and malignant nature of pulmonary hilum or mediastinal tumors was 73.85 % (48/65), specificity was 70.00 % (21/30), positive predictive value was 84.21 % (48/57), negative predictive value was 55.26 % (21/38), and accuracy was 72.63 % (69/95). The consistency K value with pathological results was 0.409, indicating moderate consistency between MSCT enhanced scanning and pathological diagnosis. ROC curve analysis results showed that the area under the curve (AUC) of MR combined with multi-slice spiral CT enhanced scanning and MSCT enhanced diagnosis of pulmonary hilum or mediastinal masses were 0.895 (95 % CI: 0.8400.950) and 0.817 (95 % CI: 0.7470.886), respectively. The sensitivity and specificity of MR combined with multi-slice spiral CT enhanced scanning in diagnosing pulmonary hilum or mediastinal masses were the highest (P < 0.001). MR HASTE sequence combined with multi-slice spiral CT enhanced scanning has good application value in distinguishing the benign and malignant nature of pulmonary hilum or mediastinal masses, and has better consistency with pathological results.