单双指数信号衰减模型在肝癌诊断中的初步研究  

The application study on DWI monoexponential and biexponential signal decay analysis in the diagnosis of hepatocellular carcinoma

作　　者：田霞[1] 谢道海[1] 陆紫微[1] 孟倩[1] 平小夏[1] 

机构地区：[1]苏州大学附属第一医院影像科,江苏苏州215006

出　　处：《实用放射学杂志》2015年第6期950-954,共5页Journal of Practical Radiology

摘　　要：目的：评价单、双指数信号衰减模型 MR 扩散加权成像（DWI）在肝细胞癌（HCC）诊断中的价值。方法本研究纳入HCC 患者28例,所有病例经手术病理证实并接受常规 MRI 扫描及多 b 值 DWI 扫描。利用后处理工作站对 HCC 的单指数、双指数 DWI 原始图像进行分析,分别测量各病灶单 b 值的表观扩散系数（ADC）值,标准表观扩散系数值（ADCst ）,慢速扩散系数值（ADCslow ）,快速扩散系数值（ADCfast ）,快速扩散所占比率（ffast ）。比较低、中、高 b 值组的 ADC 值以及 ADCst 、ADCslow 、ADCfast 、ffast值在不同分化程度 HCC 中的差异性,并将 ADC 值、ADCst 、ADCslow 、ADCfast 、ffast 值与不同分化程度的 HCC 癌进行相关性分析。结果单指数模型显示,中 b 值组与高 b 值组中,不同分化程度的 HCC 的 ADC 值之间均有统计学差异（P 〈0.05）,且 ADC 值与分化程度存在相关性（r=0.377,P 〈0.01；r=0.815,P 〈0.01）；低 b 值组中,不同分化程度的 HCC 的 ADC 值之间无统计学差异。双指数模型显示,ADCst 、ADCslow 、ADCfast 值在不同分化程度 HCC 中均存在显著统计学差异（P 〈0.01）,且均与分化程度存在相关性（r=0.932,P 〈0.01；r=0.943,P 〈0.01；r=0.938,P 〈0.01）；ffast 值在不同分化程度 HCC 中无统计学差异。结论单指数模型中,b 值≥400 s/mm2时对于区分 HCC 的分化程度有潜在的应用价值。双指数模型对于区分术前 HCC 的分化程度提供了新的、独特的信息,特别是 ADCst 、ADCslow、ADCfast 值对于鉴别 HCC 的分化程度有很大价值。Objective To evaluate mono-and bi-exponential decay models in the diagnosis of hepatocellular carcinoma （HCC）. Methods 28 patients with HCC who underwent conventional MRI imaging and diffusion-weighted imaging were collected,and all the HCC lesions were proved by operation pathology.The ADC values in mono-exponential decay model and ADCst ,ADCslow , ADCfast and ffast of the lesions in bi-exponential decay model were measured through the reconstruction of ADCmap ,ADCslow map, ADCfast map and fraction of fast ADC at a workstation.The relationships between the ADC values with low,medium and high b-val-ues and different differentiation degrees of HCC were analyzed.Moreover,the relationships between the ADCst ,ADCslow ,ADCfast , ffast values and HCC defferentiation grades were also explored.Results Significant differences in ADC value were found among differ-ent degrees of HCC differentiation in middle and high b-value groups （P 〈0.05）.A positive correlation was found between the ADC value and the degree of HCC differentiation in middle （r=0.377,P 〈0.01）and high b-value group （r =0.81 5,P 〈0.01）.There were no significant differences in ADC value among the different degrees of HCC differentiation in low b-value group.There were significant differences in the values of ADCst ,ADCslow and ADCfast among different degrees of HCC differentiation.Significant posi-tive correlations were found between the values of ADCst ,ADCslow and ADCfast and the degree of differentiation （P 〈0.01）.There were no significant differences in the values of ffast among different degrees of HCC differentiation.Conclusion ADC value in mono-exponential decay model plays a potential role in the diagnosis of different differentiation degree of HCC with a b value ≥400 s/mm2 .Furthermore,the parameters in bi-exponential decay model,especially the values of ADCst ,ADCslow and ADCfast ,can provide new and unique information in the distinction of different degrees of HCC differentiation.

关 键 词：肝细胞癌 磁共振成像 扩散加权成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]