ADC值在鉴别肝脏良恶性局灶性病变的应用价值  

Value of ADC in determination of benign or malignant focal liver lesions

作　　者：张海兵[1] 钟喨[2] 

机构地区：[1]上海交通大学医学院附属新华医院崇明分院放射科,上海202150 [2]上海交通大学医学院附属仁济医院放射科,上海200001

出　　处：《医学影像学杂志》2013年第7期1044-1048,共5页Journal of Medical Imaging

摘　　要：目的评价ADC值在鉴别肝脏良恶性局灶性病变(focal liver lesion,FLL)的诊断价值。方法采用signa3.0T MR对306例共391个FLL进行屏气DWI成像(b=800s/mm2),包括肝囊肿78灶,成熟肝脓肿23灶,肝血管瘤39灶,FNH\肝腺瘤17灶,原发性肝癌121灶,胆管细胞癌45灶,肝转移癌68灶。DWI图像经GE公司AW4.2工件站后处理得到ADC图,测量以上各类病灶的ADC值,统计分析良恶性性FLL的ADC值及其差异。结果良恶性FLL的平均ADC值(×10-3 mm2/s)分别为2.63±0.35、1.18±0.41,差异有统计学意义(P=0.007)。以ADC≤1.64×10-3 mm2/s诊断恶性FLL的敏感性、特异性和准确率分别为:87%、81%、84%。结论恶性FLL的ADC值明显低于良性,以ADC值能明显提高对肝脏局灶性病变良恶性的鉴别诊断能力。Objective To investigate whether ADC measurements may be utilized to differentiate malignant from benign focal liver lesions （FLL）. Methods Three hundred and six cases with three hundred and ninty one FLLs were enrolled in this study, which included seventy eight cysts, twenty three matured abscesses, thirty nine hemangiomaes, seventeen FNHs/adenomaes, one hundred and twenty one HCCs, forty five cholangiocarcinomaes, and sixty eight metastasises. All cases were performed with a breath-hold DWI sequence （b=800 s/ram2） and the image data were transferred to GE AW workstation （Version 4.2） for post processing. Results The ADC value（X 10.3 mm2/s）for benign and malignant group was 2.63%0.35 versus 1.18±0.41. The difference in ADC values between two groups showed statistically significant （ P〈 0. 007）. The sensitivity, specificity and accuracy for differentiating malignant from benign FLLs with a cut-off point of 1.64X 10-s mm2/s were 87%, 81%, 84%, respectively. Conclusion ADC values for malignant FLLs are lower than those for benign. The measurement of ADC values provide quantifiable diffusion information for FLLs and enable us to improve the diagnostic accuracy for FLLs.

关 键 词：肝脏局灶性病变 磁共振成像 扩散加权成像 表观扩散系数 

分 类 号：R575[医药卫生—消化系统]