MR扩散加权成像ADC值及ADCDR值鉴别诊断肝实性病变良恶性的价值  

Diagnostic efficiency of apparent diffusion coefficient and decline rate of apparent diffusion coefficient in differentiating benign and malignant solid focal liver lesions by diffusion weighted magnetic resonance imaging

作　　者：黄宏伟[1] 顾亚萍[2] 应明亮[1] 舒锦尔[1] 潘江峰[1] 潘勇浩[1] 

机构地区：[1]浙江大学金华医院放射科,浙江金华321000 [2]浙江大学医学院附属第一医院放射科,浙江杭州310003

出　　处：《临床研究》2017年第6期165-166,184,共3页Clinical Research

摘　　要：目的 探讨表观扩散系数（ADC）值及表观扩散系数下降率（ADCDR）在肝脏实性病变良恶性鉴别诊断中的应用价值.方法 病灶数150个（其中恶性97个、良性53个）.均进行多b值扩散加权成像并生成不同b值下ADC图像.应用ROC曲线评价ADC值及ADCDR值对肝脏良恶性病变鉴别诊断价值.结果 肝脏良、恶性病变组的平均ADC值及ADCDR值差异均有统计学意义（P＜0.05）.ADC值诊断肝脏病变以b值800 s/mm2时1.35×10-3 mm2/s为阈值的效能最高,敏感性、特异性、准确性及曲线下面积分别为79.3%、83.0%、82.0%、0.882.ADCDR值诊断肝脏病变以b值（600~1200 s/mm2）时26.52%为阈值的效能最高,敏感性、特异性、准确性及曲线下面积分别83.3%、89.7%、83.6%、0.932.结论 ADC值及ADCDR值对肝脏良恶性病变的鉴别诊断均具有一定价值,其中以b值（600~1200 s/mm2）的ADCDR值的鉴别诊断价值最大.Objective To evaluate the diagnostic contribution of ADC and ADCDR in differentiating benign and malignant liver lesions. Methods Analysis 150 lesions （97 malignant lesions, 53 benign lesions）, all patients underwent multi b value diffusion weighted imaging. ROC curve analyses were conducted to evaluate the utility of ADC and ADCDR in differentiating liver diseases. Results The differences between the mean ADC values and ADCDR values of benign and malignant lesions were statistically significant （P〈0.05）. The ADC value （threshold was 1.35×10-3 mm2/s at b value of 800 s/mm2） and the ADC- DR value （threshold was 26.52% at b value of 600-1 200 s/mm2） were effective in diagnosis benign and malignant liver le- sions; the sensitivity, specialty, accuracy and area of under curve （AUC） were 79.3%,83.0%,82.0%,0.882 and 83.3%, 89.7%,83.6% ,0.932 respectively. Conclusion The mean ADC and ADCDR values are useful for differentiating malignant from benign lesions, and ADCDR with b values （600-1 200 s/mm2） demonstrates the highest diagnostic effciency.

关 键 词：肝脏病变 弥散加权成像 下降率 诊断 

分 类 号：R739.4[医药卫生—肿瘤]