扩散加权成像对肝脏常见含脂质肿瘤的鉴别诊断  

Differential Diagnosis of Common Liver Lipid-containing Tumors Using Diffusion Weighted Imaging

作　　者：任洪伟[1,2] 安维民[1] 董景辉[1] 刘长春[1] 叶慧义[2] REN Hongwei AN Weimin DONG Jinghui LIU Changchun YE Huiyi(Department of Radiology, PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军第302医院放射科,北京100039 [2]解放军总医院放射诊断科,北京100853

出　　处：《中国医学影像学杂志》2017年第6期457-460,464,共5页Chinese Journal of Medical Imaging

基　　金：首都医学发展科研专项资助项目(2011-5001-05)

摘　　要：目的探讨扩散加权成像(DWI)技术在肝脏常见含脂质肿瘤鉴别诊断中的应用价值。资料与方法回顾分析2011年1月—2015年8月解放军第302医院经病理确诊的60例肝脏含脂质肿瘤,包括25例肝细胞癌(HCC)、20例肝腺瘤(HA)、15例肝脏血管平滑肌脂肪瘤(HAML),分别测量肿瘤的表观扩散系数(ADC)值、ADC_(肿瘤)_/ADC(肝脏)(r ADC),并分析常规MRI表现。结果 3种常见肝脏含脂质肿瘤的MRI表现各有特征,HCC、HA、HAML的平均ADC值分别为(1.225±0.221)×10^(-3) mm^2/s、(1.318±0.212)×10^(-3) mm^2/s、(1.317±0.297)×10^(-3) mm^2/s(b=800 s/mm^2),r ADC分别为1.004±0.151、0.984±0.146、1.027±0.223,三者间ADC、r ADC差异均无统计学意义(P>0.05)。结论 ADC及r ADC在肝脏常见含脂质肿瘤中无鉴别诊断价值,常规MRI及增强特征是诊断的主要依据。Purpose To investigate the application value of diffusion weighted imaging（DWI） in differential diagnosis of common liver lipid-containing tumors. Materials and Methods Methods Sixty patients with pathologically confirmed liver lipid-containing tumors from January 2011 to August 2015 were retrospectively analyzed, including 25 cases of hepatocellular carcinoma（HCC）, 20 cases of hepatic adenoma（HA） and 15 cases of hepatic angiomyolipoma（HAML）. Apparent diffusion coeffi cient（ADC） value and ratio of ADCtumor/ADCliver（r ADC） of tumors were respectively measured. Routine MRI findings were analyzed. Results The MRI fi ndings of these three common liver lipid-containing tumors were with their own characteristics. For HCC, HA and HAML, the average ADC value was（1.225±0.221）×10^-3 mm^2/s,（1.318±0.212）×10^-3 mm^2/s and（1.317±0.297）×10^-3 mm^2/s, respectively,（b=800 s/mm^2）; the average r ADC value was 1.004±0.151, 0.984±0.146 and 1.027±0.223, respectively. There was no signifi cant difference in ADC and r ADC among these three tumors（P〈0.05）. Conclusion ADC and r ADC had no differential diagnosis value in common liver lipid-containing tumors. Routine MRI signals and enhanced imaging features are the main diagnostic basis.

关 键 词：癌 肝细胞 肝肿瘤 腺瘤 血管肌脂瘤 磁共振成像 扩散加权成像 表观扩散系数 诊断 鉴别 

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]