背景抑制体部磁共振弥散加权成像在肝内局灶性病变诊断方面的应用价值研究  

MR diffusion weighted imaging with background suppression in the diagnosis and differential diagnosis of focal hepatic lesions

作　　者：胡奕[1] 郭启勇[1] 

机构地区：[1]中国医科大学附属第二医院放射科,辽宁沈阳110004

出　　处：《中国临床医学影像杂志》2006年第10期547-550,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:评价背景抑制磁共振弥散加权成像在肝脏局灶性病变诊断中的应用价值。材料与方法:将60例病人的89个肝脏局灶病变作为研究对象,包括28处肝转移瘤,32处原发性肝癌,8个血管瘤,17个肝囊肿,胆源性肝脓肿2处以及局灶性结节增生1处,胆管腺癌1处。行背景抑制磁共振弥散加权成像后,计测并比较肝内各种病变的ADC值;对部分病人行全身多部位大范围扫描,查找远隔病变。结果:①肝内良性病变ADC值明显高于恶性病变(P<0.05),以1.6×10-3mm2Ds作为良恶性病变ADC值的界限,敏感度和特异度均>90%。②原发性肝癌、转移瘤、血管瘤及肝囊肿的ADC值呈递增趋势。③血管瘤、转移瘤及原发性肝癌与肝脏的比值依次递增(P<0.05)。④对部分病人行大范围扫描后可以查找出原发灶或远隔器官病变。结论:背景抑制磁共振弥散加权成像在肝脏占位病变的诊断方面有较高的临床应用价值。Objective： To study the value of MR diffusion weighted imaging with background suppression（DWIBS） in the diagnosis and differential diagnosis of focal hepatic lesions. Materials and Methods： Eighty-nine focal hepatic lesions of 60 patients were brought into study, including 28 hepatic metastases, 32 hepatic cellular earcinomas（HCC）, 8 hemangiomas, 17 hepatic cysts, 2 hepatic abscesses, 1 focal nodular hyperplasia and 1 biliary adenocarcinoma. Values of apparent diffusion coeffieients（ADCs） were calculated and compared. To find remote lesions, large-scale DWIBS with 3D-MIP reconstruction was performed on several patients. Results： ADC values of benign lesions were higher than those of malignant ones（P〈0.05） and 1.6×10^-3mm^2/s can be set as the criteria for benign lesions versus malignancy with both sensitivity and specificity higher than 90%. ADC decreased in HCC and metastasis, while that of hemangioma and hepatic cyst increased in turn. The ADClesion/ADCliver ratio can be used to differentiate HCC, metastasis and hemangioma（P〈0.05）. Remote lesions were found on some patients by large-scale scanning, which can confirm the diagnoses of metastasis. Conclusion： MR DWIBS may be a useful tool for diagnosis and differential diagnosis of focal hepatic lesions.

关 键 词：肝肿瘤 磁共振成像 弥散 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]