磁共振LAVA增强及DWI在肝结节性病变与小肝癌诊断的对比研究  

Comparative study of MRI LAVA dynamic enhanced and diffusion weighted imaging in the diagnosis of Intrahepatic nodular lesions and small liver carcinoma

作　　者：费西平 顾瑞基[1] 岑贤友[1] 覃志颖[1] 张应和[1] 梁晓芬[1] 

机构地区：[1]广州医学院附属广佛医院(佛山市南海区第二人民医院)影像中心,广东528251

出　　处：《吉林医学》2014年第17期3730-3731,共2页Jilin Medical Journal

基　　金：佛山市科技局立项课题[项目编号:201008140]

摘　　要：目的:探讨磁共振动态增强检查和水分子扩散加权成像(DWI)在肝结节性病变与小肝癌诊断及鉴别诊断的价值及局限性,对比研究两种检查方法对肝脏占位性病变的检出效能。方法:收集125例肝脏占位性病变患者共172个病灶,常规MRI平扫、LAVA增强及DWI检查(b值分别为0和500 s/mm2),对比分析LAVA三期扫描(A组)、DWI(B组)及这两种方法联合应用(C组)在肝结节病及小肝癌检出和定性的诊断价值。结果:在结节检出方面:A组检出146个结节,B组检出138个,C组检出172个,三组组间比较差异有统计学意义(χ2=35.756,P<0.01)。在结节的定性诊断方面:在取得临床或病理证实的116个病例中,A组诊断正确82例(70.7%),B组诊断正确76例(65.5%),C组为108例(93.1%),三组组间比较差异有统计学意义(A组与C组对比χ2=19.653,P<0.01;B组与C组对比χ2=21.274,P<0.01)。结论:动态增强扫描联合DWI有助于提高肝脏结节性病变的检出率,增加诊断信息,提高诊断正确率。Objective To study the value in diagnosis and differential diagnosis of MRI dynamic enhanced and DWI in the diagnosis of intrahepatic nodular lesions and small liver carcinoma,comparative study the detection efficacy of the two examine. Methods Collected 125 patientS with Intrahepatic occupying lesion with total 172 focal hepatic lesions were examined by routine conventional and dynamic en-hanced MRI incombination with DWI（SE/ EPI technique,b value as 0 and 500s/ mm2 respectively）. The values of detection and diagnosis of Intrahepatic nodular lesions and small liver carcinoma by dynamic enhanced MRI（groupA）,DWI（groupB）and dynamic enhanced MRI in combination with DWI（groupC）were comparedandanalyzed. Results In the respect of detecting intra - hepatic small nodular lesions,146 intra - hepatic small nodular lesions were detected by（groupA）,138 lesions by（groupB）and 172 lesions by（groupC）,significant statistical differences were existed（χ2 = 35. 756,P 〈 0. 01）. Inthe respect of qualitative diagnosis of intra - hepatic small nodular lesions,there were 116 clinical or pathology proved nodular lesions,correct diagnosis was obtained in 82 cases（70. 7% ）by（groupA）,76cases（65. 5% ）by （group B）,108 cases（93. 1% ）by（group C）,with significant statistica1 difference（group A）compared with（group C）χ2 = 19. 653,P 〈0. 01;（group B）compared with（group C）χ2 = 21. 274,P 〈 0. 01）. Conclusion DWI in combination with LAVA dynamic enhanced addable diagnostic information,raise correct rate in diagnosis.

关 键 词：动态增强 DWI 肝结节性病变 小肝癌 

分 类 号：R735.7[医药卫生—肿瘤]