MR 动态增强联合扩散加权成像对壶腹区良恶性病变的鉴别  

Role of diffusion weighted imaging and dynamic contrast-enhanced MRI in assessing malignant and benign lesion in periamapullary regions

作　　者：周研[1] 曾向廷[1] 吴先衡[1] 郑少燕[1] 

机构地区：[1]汕头市中心医院CT/MR室,广东汕头515013

出　　处：《实用放射学杂志》2016年第5期733-736,共4页Journal of Practical Radiology

摘　　要：目的：研究M R动态增强联合扩散加权成像（DWI）在鉴别壶腹区良恶性病变的价值。方法回顾性分析43例胆总管下段狭窄患者的M R动态增强及DWI的数据。其中包括32例恶性病变和11例慢性炎症。1位影像医生对壶腹周围良恶性病变的M R动态增强信号强度及DWI信号进行分析，另外2位影像医生对壶腹周围病变的M R动态增强影像以及M R动态增强联合DWI影像进行评估。应用 Logistic回归分析比较灵敏度及特异性。结果壶腹周围良恶性病变MR动态增强表现差异无统计学意义；DWI影像中，壶腹周围癌比炎症更多地表现为高信号，表观扩散系数（ADC）图表现为低信号（P＜0．001）。2位读片者在结合DWI影像后对恶性壶腹周围病变的诊断灵敏度均有提高，分别从84．4％提高到96．9％和从87．7％提高到96．6％。结论 M R动态增强联合DWI可提高鉴别壶腹周围区良恶性狭窄的诊断准确率。Objective To define the value of DCE and DWI in assessing malignant and benign lesion in periamapullary regions . Methods The data of dynamic contrast enhancement magnetic resonance imaging （DCE‐MRI） and diffusion‐weighted imaging（DWI） of 43 patients （32 malignant and 11 benign lesions） were analyzed retrospectively ,who have been diagnosed as biliary strictures in ampullary regions .One radiologist compared the signal intensity of DCE‐MRI and DWI of malignant and benign periamapullary le‐sions .Two other radiologists assessed data of DCE‐MRI and data of combined DCE‐MRI and DWI from those periamapullary lesions respectively .And then we compared the diagnostic sensitivity and specificity of each type of data by receiver operating characteristic （ROC） curve analysis .Results Malignant and benign periamapullary lesions showed no statistically significant difference on DCE‐MRI;Malignant periampullary lesion were more frequently appeared hyperintense than benign lesions on DWI ,and hypointense on ADC （P〈0 .001） .Diagnostic accuracy improved from 84 .4% to 96 .9% and 87 .7% to 96 .6% for both reviewers after adding DWI on diagno‐sis of malignant periampuullary lesions .Conclusion The combination of DCE‐MRI and DWI can improve the diagnostic accuracy for differentiating malignant from benign strictures in the periampullary region .

关 键 词：扩散加权成像 MR动态增强 壶腹周围病变 

分 类 号：R445.2[医药卫生—影像医学与核医学] R572[医药卫生—诊断学]