磁共振扩散加权成像在肝外胆管癌诊断中的应用研究  

The Application of Diffusion Weighted Imaging in Diagnosing Extrahepatic Cholangiocarcinoma

作　　者：王余 王海平 彭鹏 马梦华 韩德昌 

机构地区：[1]河北省唐山市工人医院MR室,063000 [2]河北省唐山市工人医院肝胆外科,063000

出　　处：《临床放射学杂志》2011年第10期1467-1470,共4页Journal of Clinical Radiology

基　　金：2010年唐山市科学技术研究与发展计划指导项目(编号:10130251a)

摘　　要：目的探讨MR扩散加权成像(DWI)及表观扩散系数(apparent diffusion coefficient,ADC)值对肝外胆管癌的诊断价值。资料与方法回顾性分析58例经手术病理证实的肝外胆管癌患者的MRI原始资料,包括不同b值的DWI(b值为100 s/mm2、300 s/mm2、500 s/mm2、800 s/mm2、1000 s/mm2)及常规MRI平扫(T2WI、T1WI)。测量不同b值时肝外胆管癌病灶ADC值,计算病灶与正常肝脏间对比噪声比(CNR),根据HE染色病理图片记录肝外胆管癌细胞密度,并进行分析。结果 DWI对肝外胆管癌病灶的信号显示优于T2WI及T1WI。随着b值的增大,病灶ADC值逐渐降低,病灶与正常肝脏间CNR呈逐渐下降趋势,差异有统计学意义(P<0.05)。不同b值时,肝外胆管癌病灶ADC值与细胞密度之间均呈负相关(P<0.05);b=800 s/mm2时,其相关性最高(r=-0.81,P<0.05)。结论 DWI能较清楚地显示肝外胆管癌病灶,b值为800 s/mm2时最佳,与ADC值测量共同分析,有助于肝外胆管癌病灶的检出。Objective To evaluate the values of diffusion weighted imaging（DWI） and apparent diffusion coefficient（ADC） in diagnosing extrahepatic cholangiocarcinoma.Materials and Methods Fifty-eight patients with extrahepatic cholangiocarcinoma proved by operation and pathology performed DWI（b=100s/ mm2,300s/ mm2,500s/ mm2,800s/ mm2,1000 s/ mm2,respectively） and routine MRI（T2WI,T1WI） examination.The ADC value of extrahepatic cholangiocarcinoma,contrast-noise ratio（CNR）of lesion and normal liver were measured respectively.The cellularity density of extrahepatic cholangiocarcinoma was recorded according to hematoxylin and eosin（HE） staining.Results The sensitivity of DWI in detecting extrahepatic cholangiocarcinoma is higher than that of T2WI and T1WI.The ADC values and CNR decreased as b values increased（P〈0.05）.There was negative correlation between the ADC value and the cellularity density of extrahepatic cholangiocarcinoma,especially when b value was 800 s/mm2（r=-0.81,P〈0.05）.Conclusion Extrahepatic cholangiocarcinoma can be showed clearly on DWI,especially when b value was 800 s/mm2.DWI combined with ADC value is helpful in detecting extrahepatic cholangiocarcinoma.

关 键 词：磁共振成像 胆管癌 扩散加权成像 表观扩散系数 

分 类 号：R735.8[医药卫生—肿瘤]