ADC值在肝脏局灶性病变定量诊断中的价值  

Value of Apparent Diffusion Coefficient in Quantitative Diagnosis of Focal Liver Lesion

作　　者：张海兵[1] 钟喨[1] 许建荣[1] 路青[1] 卞柳利[2] 

机构地区：[1]上海交通大学医学院附属仁济医院放射科,200025 [2]上海交通大学医学院附属新华医院崇明分院放射科,202150

出　　处：《临床放射学杂志》2011年第10期1475-1479,共5页Journal of Clinical Radiology

摘　　要：目的评价MR扩散加权序列表观扩散系数(ADC)值在肝脏局灶性病变定量诊断中的价值。资料与方法对153例共187个肝脏局灶性病变(focal liver lesion,FLL)行常规MR扫描的同时增加b=0、500(s/mm2)扩散加权序列,图像经后处理拟合出ADC图,分析并比较各类病灶ADC值。结果良性FLL的ADC值分别为:肝囊肿(n=26)(3.21±0.22)×10-3mm2/s、成熟肝脓肿(n=18)(2.12±0.81)×10-3mm2/s、不成熟肝脓肿(n=7)(1.46±0.22)×10-3mm2/s、肝血管瘤(n=23)(1.92±0.36)×10-3mm2/s、肝脏局灶性结节增生(FNH)(n=8)(1.75±0.26)×10-3mm2/s。恶性FLL的ADC值分别为:肝癌(n=57)(1.23±0.43)×10-3mm2/s、胆管癌(n=12)(1.47±0.35)×10-3 mm2/s、转移癌(n=36)(1.36±0.33)×10-3 mm2/s。良恶性组的平均ADC值分别为(2.40±0.79)×10-3mm2/s、(1.29±0.41)×10-3mm2/s,差异有统计学意义。若ADC值以1.59×10-3mm2/s为界值,诊断恶性FLL的敏感性、特异性和准确性分别为88.2%、82.8%和83.7%。良性组中血管瘤和FNH差异无统计学意义;恶性组中肝癌、胆管癌及转移癌之间差异均无统计学意义。结论 ADC值定量评估FLL能明显提高肝脏局灶性病变的鉴别诊断能力。Objective To evaluate the role of ADC values in quantitative diagnosis of focal liver lesions（FLL）.Materials and Methods One hundred and fifty three cases with one hundred and eighty seven FLLs underwent MR diffusion weighted imaging（b=0、500×10-3mm2/s）additionally.The ADC values（×10-3mm2/s） of FLLs were calculated and analyzed.Results The ADC values of benign group included cysts（n=26）,mature abscesses（n=18）,immature abscesses（n=7）,hemangiomaes（n=23）,FNHs（n=8） were（3.21±0.22）×10-3mm2/s,（2.12±0.81）×10-3mm2/s,（1.46±0.22）×10-3mm2/s,（1.92±0.36）×10-3mm2/s,（1.75±0.26）×10-3mm2/s respectively.The ADC values of malignant group included HCCs（n=57）,cholangiocarcinomaes（n=12）,metastases（n=36） were（1.23±0.43）×10-3mm2/s,（1.47±0.35）×10-3mm2/s,（1.36±0.33）×10-3mm2/s,respectively.The average ADC values of benign and malignant group were（2.40±0.79）×10-3mm2/s and（1.29±0.41）×10-3mm2/s.The difference of ADC values between two groups showed statistically significant.The sensitivity,specificity and accuracy of differentiating malignant from benign with a cut-off point of 1.59×10-3mm2/s were 88.2%,82.8%,83.7%,respectively.There was no significancant difference of ADC values between hemangiomaes and FNHs in benign group and no significancant difference of ADC values between HCCs,cholangiocarcinomaes and metastases in malignant group.Conclusion ADC values play a promising role in quatitative diagnosis of FLL and enable to improve the diagnostic accuracy of FLLs.

关 键 词：磁共振成像 扩散加权 表观扩散系数 肝局灶性病变 

分 类 号：R445.2[医药卫生—影像医学与核医学]