MR弥散加权成像及ADC值对小肝癌的诊断价值  

Diagnostic value of diffusion-weighted MR imaging and apparent diffusion coefficient values in small hepatocellular carcinoma

作　　者：齐晓辉[1] 时高峰[1] 王琦[1] 李如迅[1] 许茜[1] 

机构地区：[1]河北医科大学第四医院CT室,河北石家庄050011

出　　处：《实用放射学杂志》2013年第7期1112-1115,共4页Journal of Practical Radiology

摘　　要：目的通过对伴肝硬化的临床诊断或可疑小肝癌患者进行MR扩散加权成像（DWl）及多期增强扫描，研究DWI及ADC值对小肝癌的检出敏感性，得出诊断小肝癌的ADC最佳界值。方法42例临床诊断或怀疑小肝癌患者进行DWI和多期增强扫描，DWI采用b值0，800s／mm2。根据病灶DWl后的图像测量ADC值并进行统计学分析。结果DWI、T1W1、T2WI序列对肝脏小病灶的检出率分别为94．34％、79．25％、83．02％。小肝癌的ADC值小于肝硬化实质和良性病变的ADC值，且它们之间差异有统计学意义（P值分别为0．005和0．017）。当诊断良恶性的ADC临界值设为1．176×10。s／mm2时，敏感度为70％，特异度为81．2％。结论DWI对肝脏病变的检出率高于常规T1WI和T2WI。小肝癌的ADC值小于良性病变。ADC值有助于良恶性的诊断。Objective To evaluate the sensitivity of diffusion-weighted MR imagi,lg（DWl） and explore the clinical threshold of ap- parent diffusion coefficient（ADC} values in diagnosis of small hepatocellular carcinoma （SHCC） in pal ients with cirrhosis using DWI and MR dynamic scanning. Methods Forty-two patients with confirmed small hepatocellular carcinoma or suspicious small hepato- cellular carcinoma patients underwent CT scan, CT perfusion imaging, DWI and MR dynamic scanning. The DWI was performed with different b value（0,800 s/rnm2 ）. The ADC values of all lesions were calculated and analyzed. Results The detection sensitivi- ties of DWI,T1WI and TzWI were 94.34% ,79.25~,83.02% respectively and the mean ADC values of SHCC,cirrhotic liver paren- chymaandbenignlesionwere（1.071±0.248）×10^-3s/mm2,（ 1.185±0.273 ）10 -3/mm2,（ 1. 490 ± 0.562 ）×10-s/mm2 re- spectively . There was statistically significant difference in ADC value between SHCC lesions and cirrhotic liver parenehyma, SHCC lesions and benign lesion（ P=0. 005 , P=0. 017）. When the ADC critical diagnosis value of benign and malignant lesion was set at 1. 176 ±10^-3 s/mm2 ,the sensitivity and specificity reached 70% and 81.2%, respectively. Conclusion The detection sensitivity of DWI is higher than those of T1 WI and T2 WI. DWI and ADC value can provide important information for detection and diagnosis of SHCC.

关 键 词：扩散加权成像 小肝癌 表观扩散系数 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]