扩散加权成像在局灶性肝脏病变的临床应用  

Applications of MRI Diffusion-weighted Imaging in the Diagnosis of Focal Hepatic Lesions

作　　者：胡兴荣[1] 覃大明 张丽君[1] 陈华东[1] 张峻[1] 

机构地区：[1]武汉大学恩施临床学院(恩施土家族苗族自治州中心医院)影像科,湖北恩施445000

出　　处：《中国CT和MRI杂志》2016年第2期69-72,共4页Chinese Journal of CT and MRI

摘　　要：目的利用磁共振扩散加权成像(DWI)对局灶性肝脏病变进行定量分析,探讨其在局灶性肝脏病变中的应用价值。方法应用SE-EPI DWI(b=500s/mm2)序列,对局灶性肝脏病变111例(原发性肝细胞癌35例,周围型胆管细胞癌7例,转移瘤25例,局灶性结节增生3例,血管瘤22例,囊肿19例)进行扫描,测量病变的表观弥散系数(ADC)值,比较不同疾病ADC值的差异。结果 b值选用500s/mm2时,正常肝脏的ADC值为(1.49±0.14)×10-3mm2/s,原发性肝细胞癌、胆管细胞癌、转移瘤、局灶性结节增生、血管瘤和囊肿的ADC值分别为(0.93±0.14)×10-3m m2/s、(0.9 7±0.1 5)×1 0-3m m2/s、(1.0 6±0.1 7)×1 0-3m m2/s、(1.5 3±0.2 9)×1 0-3m m2/s、(2.1 8±0.2 3)×1 0-3m m2/s和(3.15±0.21)×10-3mm2/s。肝癌和转移瘤的ADC值小于正常肝脏(P<0.01),血管瘤和囊肿的ADC值大于肝脏(P<0.01)。局灶性结节增生与肝脏的ADC值之间、肝癌与转移瘤的ADC值之间无统计学差异(P>0.05)。结论磁共振弥散成像及ADC值测定,能较准确的判断局灶性肝脏病变的性质,对其诊断及鉴别诊断有一定价值。Objective Objective To evaluate the value of diffusion-weighted imaging（DWI）in the diagnosis of focal hepatic lesions by quantitative analysis. Methods A total of 111 patients with focal hepatic lesions（including 35 cases of hepatocellular carcinoma, 7 cases of peripheral cholangiocarcinoma,25 cases of hepatic metastatic tumors,3 cases of focal nodal hyperplasia,22 cases of hepatic hemangiomas and 19 cases of hepatic cysts）were examined by MRI SE-EPI and DWI（b=500/mm2） sequence, to measure and analyze the difference of apparent dispersion conficient（ADC） values. Results Results When b=500s/mm2,the average ADC value of normal hepatic tissue was（1.49±0.14）×10-3mm2/s,the average ADC values of hepatocellular carcinoma、metastatic tumor、focal nodal hyperplasia、hemangioma and cyst were（0.93±0.14）×10-3mm2/s,（0.97±0.15）×10-3mm2/s,（1.06±0.17）×10-3mm2/s,（1.53±0.29）×10-3mm2/s,（2.18±0.23）×10-3mm2/s and（3.15±0.21）×10-3mm2/s. The ADC value of hepatocellular carcinoma and metastatic tumor lower than that of normal hepatic tissue（P〈0.001）.The ADC value of hemangioma and cyst higher than that of normal hepatic tissue（P〈0.001）.The ADC value had no significant differences between focal nodal hyperplasia and normal hepatic tissue, hepatocellular carcinoma（P〈0.05）. Conclusion According to DWI and ADC values, the quality of hepatic lesions can be exactly diagnosed, which has a certain value in the diagnosis and differential diagnosis of focal hepatic leions.

关 键 词：磁共振成像 弥散 表观扩散系数 肝脏局灶性病变 

分 类 号：R44[医药卫生—诊断学]