3.0T MRI扩散加权成像在鉴别肝脏转移瘤与肝内胆管细胞癌中的价值  

3.0T MRI differential diagnosis of hepatic metastases and intrahepatic cholangiocarcinoma by using diffusion-weighted imaging

作　　者：毕聪[1] 孙文阁[1] 卢涛[1] 戚喜勋[1] 

机构地区：[1]中国医科大学附属第一医院放射科,辽宁沈阳110001

出　　处：《中国现代普通外科进展》2015年第5期378-382,共5页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:分析研究扩散加权成像在鉴别肝脏转移瘤和肝内胆管细胞癌中的价值。方法:回顾性分析病理证实的肝脏转移瘤患者和肝内胆管细胞癌患者的MRI原始资料,包括DWI序列和常规MRI平扫序列(包括T1WI和T2WI)。两种病例各14例,测得其表观扩散系数(ADC)值、瘤/肝值,以及肿瘤与邻近肝实质之间的差异,并进行比较。结果:受检28例患者共28个肿瘤,所有肿瘤在ADC图上均呈现高信号,T2WI呈现稍高信号,T1WI呈现稍低信号,边界较为清楚。肝脏转移瘤平均ADC值为0.943±0.132,肝内胆管细胞癌平均ADC值为1.001±0.008,两者差异无统计学意义(t=0.695,P>0.05)。肝脏转移瘤的瘤/肝值显著低于肝内胆管细胞癌(t=2.780,P<0.05)。肝脏转移瘤和肝内胆管细胞癌的ADC值均低于邻近肝实质(t=6.143、8.545,P<0.05)。结论:磁共振DWI序列中测得的瘤/肝值能够对肝内转移瘤和肝内胆管细胞癌的鉴别诊断提供有价值的信息。Objective： Analysis and study of diffusion weighted imaging in liver metastases and intrahepatic bile duct carcinoma in the differential diagnosis value. Methods： Proved by surgical pathology were retrospectively analyzed in patients with liver metastases and intrahepatic bile duct carcinoma in patients with MRI raw data, including the DWI sequence and conventional MRI can scan sequence（including T1 WI and T2WI）, Two of these cases（n = 13）, measured the apparent diffusion coefficient（ADC）value、value of tumor/liver, and the differences between tumor and adjacent liver parenchyma, and the comparison. Results： 28 cases, a total of 28 patients with tumor, all tumors were showing high signal on the ADC map, T2 WI show slightly higher signal, T1 WI appears slightly low signal, boundary is more clear. The average ADC values for two kinds of tumor liver metastases 0.943±0.132 and intrahepatic bile duct carcinoma was 1.001±0.008, there was no statistically significant difference between the two（t=0.695,P0.05）. Liver metastases tumor/hepatic value is significantly lower than that of intrahepatic bile duct carcinoma（t=2.780,P0.05）. Metastases to the liver and intrahepatic bile duct carcinoma of ADC values were lower than the adjacent liver parenchyma（t=6.143、8.545,P0.05）. Conclusion： Magnetic resonance DWI sequence can measured tumor/liver to metastases in the liver and the differential diagnosis of intrahepatic bile duct carcinoma provide valuable information.

关 键 词：肝肿瘤 磁共振成像 扩散加权成像 

分 类 号：R735.7[医药卫生—肿瘤]