胆囊癌多b值磁共振扩散加权成像的临床应用  

Clinical usefulness of multiple b values of diffusion-weighted MR imaging for detection of gallbladder cancer

作　　者：蔡崧[1] 崔兴宇[2] 王国祥[1] 孟祥鸿[1] 王成达[1] 蒋兆贯[1] 顾光官[1] 

机构地区：[1]江苏省无锡市中医医院放射科,江苏无锡214001 [2]南京医科大学附属无锡人民医院影像科,江苏无锡214023

出　　处：《医学影像学杂志》2013年第10期1579-1583,共5页Journal of Medical Imaging

基　　金：江苏省自然科学基金项目(编号:BK2012541);无锡市科技支撑-社会发展计划(编号:CSE01N1213);无锡市医院管理中心医学技术重大项目(编号:YGZF1103)

摘　　要：目的评价不同b值磁共振扩散加权成像对胆囊癌的显示能力和最佳b值的选择;并探讨表观扩散系数值与胆囊癌分化程度的关系。方法对33例胆囊癌患者术前行常规MRI和DWI检查。测量肿瘤的ADC值,计算多b值扩散成像和T2WI图像中的信噪比、对比噪声比及信号强度比等数据;对经手术病理证实的33例胆囊癌患者进行病理分级,比较不同b值时不同分化程度胆囊腺癌的ADC值;并进行统计学分析。结果 33例胆囊癌病灶均被DWI检出,肿瘤的SNR和肿瘤与正常肝脏的CNR随b值的增加逐渐下降,而肿瘤的SIR随b值增加逐渐升高。b值800s/mm2时DWI图像肿瘤与正常肝脏的CNR、肿瘤的SIR和SNR均高于T2WI,差异有统计学意义(P<0.05)。胆囊腺癌的ADC值随着b值增高逐渐变小,差异有统计学意义(P<0.05)。结论胆囊癌扩散加权成像的最佳b值为800s/mm2,可以得到胆囊癌的良好显示;胆囊腺癌ADC值随着肿瘤分化程度的降低而减小。Objective To measure the sensitivity of diffusion-weighted imaging, determine the most appropriate b value for DWI and also, to explore the correlation between the apparent diffusion coefficient to and the degree of gallbladder cancer differentiation. Methods Preoperative diffusion-weighted imaging and magnetic resonance examinations were performed for 33 patients with gallbladder cancer. Tumor ADC values were measured, and the signal-to-noise ratio, contrastto-noise ratio, and signal-intensity ratio between the diffusion-weighted images with various b values as well as the T2weighted images were calculated. 33 patients pathologically confirmed were pathologically graded to compare the ADC value with different b values of tumor at different degrees of differentiation, and the results were statistically analyzed. Results All 33 cases of gallbladder cancer were detected by DWI. As the b value increased, tumor signal-to-noise ratio and contrast-to-noise ratio between the tumor and normal liver gradually decreased, but the tumor signal-intensity ratio gradually increased. When b=800s/mm2, contrast-to-noise ratio between tumor and normal liver, tumor signal-intensity ratio, and tumor signal-noise ratio of diffusion-weighted images were all higher than those of T2-weighted images; the differences were statistically significant （ P d0.05）. As the b value increased, the tumor ADC value gradually declined. As the degree of differentiation decreased, the tumor ADC value declined. Conclusion The b value of 800s/mm2 was the best in DWI of gallbladder cancer; the lesion ADC value declined as the degree of cancerous tissue differentiation decreased.

关 键 词：胆囊癌 磁共振成像 扩散加权成像 B值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.8[医药卫生—诊断学]