肝癌导致门静脉癌栓的ADC和DWI表现及其诊断价值  

Apparent Diffusion Coefficient and Diffusion Weighted Imaging Findings in Portal Vein Tumor Thrombus Caused by Hepatic Carcinoma

作　　者：黄克勇[1] 丁汇清[1] 李长城[1] 张名忠[1] 李春阳[1] 

机构地区：[1]江苏省连云港市东方医院(徐州医学院附属连云港东方医院)影像科,江苏连云港222042

出　　处：《中国医学影像学杂志》2015年第8期602-605,共4页Chinese Journal of Medical Imaging

基　　金：2012年江苏省连云港市卫生局指令性科研项目(1236)

摘　　要：目的探讨肝癌导致门静脉癌栓(PVTT)的表观扩散系数(ADC)和扩散加权成像(DWI)表现及其诊断价值。资料与方法选取经临床和MRI诊断为肝癌导致门静脉癌栓的31例患者,共43个肝癌癌灶、63个门静脉主干支癌栓。31例均行常规MRI、DWI和ADC成像,观察肝癌癌灶和PVTT的MRI、ADC和DWI表现,分析癌灶和PVTT ADC值的相关性。结果 43个肝癌癌灶中,DWI表现为低信号、等信号和高信号分别有1个、4个和38个;其ADC表现为低信号、等信号和高信号分别有36个、5个和2个。63支PVTT中,DWI表现为低信号、等信号和高信号分别有4支、7支和52支,其ADC表现为低信号、等信号和高信号分别有54支、6支和3支。2名观察者观察癌灶ADC表现的一致性较好(Kappa=0.8334,P<0.05),观察PVTT的一致性中等(Kappa=0.5215,P<0.05)。同个体癌灶和PVTT的ADC均值分别为(1.127±0.268)×10-3 mm2/s和(1.021±0.363)×10-3 mm2/s,癌灶和PVTT的ADC值呈正相关(r=0.246,P<0.05)。结论 PVTT的ADC低信号、低ADC值和DWI高信号表现,对其定性诊断具有一定的临床应用价值。Purpose To explore the findings and diagnostic values of apparent diffusion coefficient （ADC） and diffusion weighted image （DWI） of the portal venous tumor thrombus （PVTT） caused by hepatic carcinoma.Materials and Methods Thirty-one patients with hepatic carcinoma （43 lesions） with 63 PVTT in the main branches and trunks diagnosed by clinical and MRI were enrolled. All patients underwent conventional MRI （cMRI） imaging, DWI and ADC imaging, the features of cMRI, DWI and ADC were observed, the relevance of ADC values between the hepatic carcinoma lesion and PVTT were analyzed.Results Among the total 43 lesions, DWI image showed low signal, iso-signal and high signal in 1, 4 and 38 lesions, respectively; and ADC image showed low signal, iso-signal and high signal in 36, 5 and 2 lesions, respectively. In the total 63 PVTT, DWI showed low signal, iso-signal and high signal in 4, 7 and 52 lesions, respectively;while their ADC images showed low signal, iso-signal and high signal in 54, 6 and 3 branches, respectively. There was good consistency for the results of two observers on the findings of ADC of tumor lesions （Kappa=0.8334,P〈0.05）, and a moderate consistency on that of PVTT （Kappa=0.5215,P〈0.05）. The average ADC value of tumor lesion and PVTT was （1.127±0.268）＆#215;10-3 mm^2/s and （1.021±0.363）＆#215;10-3 mm^2/s, respectively; there was a correlation of the mean values of ADC between tumor lesion and PVTT （r=0.246,P〈0.05）. Conclusion The features such as low signal and low value on ADC image and high signal on DWI obtain a certain clinical application value for qualitative diagnoses of PVTT.

关 键 词：肝肿瘤 门静脉 栓塞 磁共振成像 表观扩散系数 扩散加权成像 

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]