磁共振LAVA和DWI技术联合在肝脏良恶性病变中的诊断及鉴别诊断价值分析  

Clinical value of LAVA and DWI technology in the diagnosis and differential diagnosis of benign and malignant liver lesions

作　　者：陈体[1] 苏雪娟[1] Chen Ti;Su Xue-juan(Radiology Department of The Second People's Hospital of Nanyang,Henan Nanyang 473000)

机构地区：[1]河南省南阳市第二人民医院放射科,河南南阳473000

出　　处：《四川生理科学杂志》2018年第1期26-28,共3页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨磁共振LAVA和DWI技术联合在肝脏良恶性病变中的诊断及鉴别诊断价值。方法:随机选取2016年1月至2017年1月在我院就诊的106例(共158个病灶)肝脏占位病变患者作为研究对象,按随机数字表法将其分为磁共振肝脏增强(LAVA)技术(Liver acquisition with volume acceleration,LAVA)联合磁共振散加权成像和弥量成像DWI(Diffusion weighted imaging,DWI)技术组和DWI组,每组各53例,LAVA联合DWI组患者采取磁共振LAVA扫描联合DWI扫描,DWI组患者采取磁共振DWI扫描。观察比较两组影像扫描技术在肝脏良恶性病变中的诊断以及鉴别诊断价值。结果:(1)LAVA联合DWI组患者定性率(88.68%)高于DWI组(71.7%),LAVA联合DWI组患者病变定性准确率(91.49%)明显高于DWI组(73.68%)(P<0.05);(2)当b=500mm2·s-1时,LAVA联合DWI组肝囊肿ADC值(2.637±0.314)×10-3 mm2·s-1明显高于肝血管瘤(2.291±0.433)×10-3 mm2·s-1、肝癌(2.018±0.196)×10-3 mm·s-1(F=29.88,P<0.001)。DWI组肝囊肿ADC值(2.242±0.313)×10-3 mm2·s-1明显高于肝血管瘤(2.232±0.412)×10-3 mm2·s-1、肝癌(1.964±0.178)×10-3 mm2·s-1(F=26.33,P<0.001)。LAVA联合DWI组肝血管瘤、肝囊肿、肝癌的ADC值均高于DWI组(P<0.05);(3)肝细胞癌病灶43个,在DWI单独扫描中呈高信号,LAVA联合DWI扫描中35个(81.4%)病灶为"快进快出"式典型强化,具体表现为动脉期强化,8个病灶动脉期未明显强化。转移瘤病灶37个,在DWI单独扫描中病灶呈高信号。LAVA联合DWI扫描中17个病灶动脉期无强化,10个病灶动脉期、门静脉期、延迟期均强化。血管瘤病灶38个,在DWI单独扫描中病灶呈高信号。LAVA联合DWI扫描中20个(52.63%)病灶动脉期未明显强化,延迟扫描后边缘强化。肝囊肿病灶40个,在DWI单独扫描中病灶呈高信号。LAVA联合DWI扫描中19个(47.5%)病灶强化扫描后均未见强化。结论:磁共振LAVA联合DWI扫描应用于肝脏良恶性病变的检查中可清晰显示肝脏病变的血供特征的�Objective:To evaluate the clinical value of magnetic resonance LAVA(liver acquisition with volume Acceleration)and DWI(Diffusion weighted imaging)technology in the diagnosis and differential diagnosis of the benign and malignant liver lesions.Methods:One hundred and six patients with the space-occupying liver lesions(158 lesions)treated from January 2016 January 2017 in our hospital were selected.The subjects were randomly divided into the combined group and DWI group(n=53).The patients in combined group received the combined method of LAVA and DWI;the patients in DWI group just received the DWI technology.The clinical value of two scanning methods in the diagnosis and differential diagnosis of benign and malignant liver lesions was analyzed.Results:(1)The qualitative rate for combined group(88.68%)was significantly higher than DWI Group(71.7%);the diagnosis accuracy for combined group(91.49%)was significantly higher than DWI Group(73.68%,P<0.05);(2)when b=500 mm 2·m-1,the ADC value of hepatic cyst for combined group(2.637±0.314)×10-3 mm 2·m-1 was significantly higher than the ADC value of hepatic hemangioma(2.291±0.433)×10-3 mm 2·s-1 and liver cancer(2.018±0.196)×10-3 mm·m-1(P<0.001);for the DWI group,the ADC of liver cyst(2.242±0.313)×10-3 mm 2·m-1 was significantly higher than the ADC value of hepatic hemangioma(2.232±0.412)×10-3 mm 2·m-1 and liver cancer(1.964±0.178)×10-3 mm 2·m-1(P<0.001);the ADC value of hepatic hemangioma,hepatic cyst and liver cancer for combined group were higher than DWI Group(P<0.05);(3)based on the DWI scanning,43 hepatocellular carcinoma lesions were presented with the high signal;based on the combined method,35 lesions(81.4%)were presented with the typical reinforcement of“fast forward”-with the special manifestation of intensive signal at the arterial phase;8 lesions were not obviously intensified at the arterial phase.Based on the DWI,37 metastasis lesions were presented with high signal;based on the combined method,17 lesions were not intensified at the art

关 键 词：磁共振LAVA技术 磁共振DWI技术 肝脏良恶性病变 诊断及鉴别价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575[医药卫生—诊断学] R735.7[医药卫生—临床医学]