磁共振扩散加权成像在肝癌辨证分型中的应用研究  

Application of magnetic resonance diffusion weighted imaging in syndrome differentiation of hepatoma

作　　者：王嵩[1] 张世界[1] 李琼[1] 张建军[1] 马国骏[1] 

机构地区：[1]上海中医药大学附属龙华医院放射科,上海200032

出　　处：《上海中医药杂志》2010年第1期11-13,共3页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市科委创新项目(09YZ130)

摘　　要：目的探讨肝癌的磁共振扩散加权成像信号特征与中医辨证分型之间的关系。方法对61例肝原发癌与转移癌患者根据中医四诊合参分为气阴两虚型、气滞血瘀型、肝胆湿热型,在磁共振图像上观察肿瘤结节的形态、大小,肿瘤DWI信号改变,血管受侵改变,占位征象及周围器官侵犯转移与中医证型的关系。结果①中医证型与磁共振观察的肿瘤形态有一定相关性(P<0.05),气阴两虚型中结节型最多(18/26),气滞血瘀型则以巨块型为主(15/20)。②中医各证型中,在DWI图像上表现为不均匀的高信号,以气滞血瘀型为主(12/19);在形成癌栓的病例中,气滞血瘀型最多(8/11),发生周围侵犯者也以气滞血瘀型为主(11/16),其构成比差异均有统计学意义(P<0.05)。结论磁共振扩散加权成像作为一种新的微观辨证手段有助于中医宏观辨证,有助于疾病的诊断和证候的确立。Objective To study the relationship between magnetic resonance diffusion weighted imaging and syndrome differentiation of hepatoma. Methods Sixty-one primary or metastatic carcinoma of liver were differentiated into qi-yin deficiency syndrome, qi-blood stagnation syndrome, and dampness heat in liver and gallbladder syndrome. In magnetic resonance imaging, the tumor shape and size, the changes of DWI signals and invaded vessels, occupying signs and involvement in surrounding organs were observed and compared between different syndromes. Results The syndromes are correlated with the tumor shape（P 〈0.05 ）, nodular type primarily in qi-yin deficiency syndrome（ 18/26）, massive type in qi-blood stagnation syndrome（15/20）. In different syndromes, DWI exhibited uneven high signals, especially in qi-blood stagnation syndrome（ 12/19 ） ; tumor embolism happened most in qi-blood stagnation syndrome（8/11 ） ; involvement in surrounding organs also tmppened in qi-blood stagnation syndrome（11/16）. The constituent ratios were of statistical difference（P 〈0.05）. Conclusion As a new microscopic differentiation means, magnetic resonance diffusion weighted imaging helps syndrome differentiation and treatment.

关 键 词：肝癌 中医证型 磁共振 扩散加权成像 

分 类 号：R273[医药卫生—中西医结合] R445.2[医药卫生—中医肿瘤科]