磁共振扩散加权成像对肝脏局灶病变的价值  

Clinical application of diffusion-weighted imaging for detecting liver lesions

作　　者：卞读军[1] 胡冬煦[2] 肖恩华[1] 司徒卫军[1] 袁术文[1] 白末了[1] 贺忠[1] 杜万平[1] 杨立平[1] 

机构地区：[1]中南大学湘雅二医院放射科,湖南省长沙市410011 [2]中南大学湘雅二医院心胸外科,湖南省长沙市410011

出　　处：《世界华人消化杂志》2007年第22期2418-2423,共6页World Chinese Journal of Digestology

基　　金：国家自然科学基金项目;No.30070235;30470508~~

摘　　要：目的:探讨磁共振扩散加权成像(diffusion weighted imaging,DWI)对肝脏局灶性病变诊断和鉴别诊断的价值.方法:原发性肝癌30例,肝血管瘤12例,肝囊肿13例,正常肝36例,行常规MRI检查加DWI,b值取500 s/mm^2和800 s/mm^2,利用MRI工作站软件Functool 2.6.6i,500 s/mm^2扫描的图像得到ADC图及eADC图,800 s/mm^2扫描的图像测出mADC,eADC及瘤肝ADC比值及瘤肝eADC比值等指标,利用SPSS12.0软件进行统计学处理.结果:mADC值正常肝(1.89±0.62 10.2 mm^2/s)低于肝囊肿与肝血管瘤(2.93±0.46 10^(-3)mm^2/s,2.26±0.45 10^(-3)mm^2/s,P<0.01,P<0.05)而高于原发性肝癌(1.43±0.52 10^(-3)mm^2/s,P<0.01);肝囊肿高于肝血管瘤(P<0.01)与原发性肝癌(P<0.01);肝血管瘤高于肝细胞癌(P<0.01).eADC值正常肝高于肝囊肿而低于肝血管瘤与原发性肝癌(0.1 55±0.07 vs 0.052±0.03,0.23±0.10,0.31±0.22,P<0.05,P<0.05,P<0.01);肝囊肿低于肝血管瘤(P<0.01)与原发性肝癌(P<0.01);肝血管瘤低于肝细胞癌(P<0.01).瘤肝ADC比值肝囊肿高于肝血管瘤与原发性肝癌(1.93±0.43 vs 1.43±0.44,0.95±0.45,均p0<.01);肝血管瘤高于原发性肝癌(P<0.01),瘤肝eADC比值在不同组间比较:肝囊肿低于肝血管瘤与原发性肝癌(1.00±0.57 vs 1.63±0.36,1.46±0.74,P<0.01,P<0.05);肝血管瘤高于原发性肝癌,但无显著性差异(P>0.05).结论:DWI有利于显示肝脏病变,综合运用mADC和eADC可进一步提高鉴别诊断的正确率.AIM： To investigate the clinical application of diffusion-weighted imaging （DWI） for detecting liver lesions. METHODS： DWI and routine non-enhanced MRI were used in 91 persons who included 30 cases with primary hepatic carcinoma, 12 with hepatic hemangioma, 13 with hepatic cyst and 36 with normal liver; b values were set at 500 and 800 s/mm2, respectively. After identifying definitively diagnosable cases, mean apparent diffusion coefficient （mADC） and exponential apparent diffusion coefficient （eADC） images were acquired using MRI machine software. The four items-mADC, eADC, DI （diffusion index; the ratio of ADC values in lesion/liver）, and the ratio of eADC values in lesion/liver-were measured. Then, one-way analysis of variance was applied to compare different groups of liver foci with the same item, and further, a least significant difference test （LSD test） was utilized to multiply and compare means in those groups where the mean difference was statistically significant. RESULTS： The mADC level in normal liver （1.89 ± 0.62 10.3 mm2/s） was lower than that in hepatic cyst （2.93 ± 0.46 10.3 mm2/s） and hemangioma （2.26± 0.45 10^-3 mm^2/s） （P 〈 0.01, P 〈 0.05） but higher than hepatic carcinoma （1.43 ± 0.52 10.3 mm^2/s, P 〈 0.01）; that in hepatic cyst higher than in hepatic hemangioma and carcinoma （both P 〈 0.01）; that in hemangioma higher than in hepatic carcinoma （P 〈 0.01）. The eADC level in normal liver （0.155± 0.07） was higher than that in hepatic cyst （0.052 ± 0.03, P 〈 0.05）, but lower than in hemangioma （0.23 ± 0.10） and hepatic carcinoma （0.31± 0.22） （P 〈 0.05, P 〈 0.01）; that in hepatic cyst lower than in hemangioma and hepatic carcinoma （both P 〈 0.01）; that in hemangioma lower than in hepatic carcinoma （P 〈 0.01）. The ratio of ADC values in the lesion/liver values in hepatic cyst （1.93 ± 0.43） was higher than that in hemangioma （1.43 ± 0.44） and hepatic carcinoma （0.95 ± 0.45, bo

关 键 词：磁共振成像 扩散加权成像 肝 肝肿瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学]