应用对比增强和弥散加权MRI鉴别转移性黏液性大肠腺癌和肝脏单纯囊肿的临床价值  

The Clinical Value of Weighted MRI in Differentiating Metastatic Mucinous Colorectal Carcinoma from Simple Hepatic Cyst

作　　者：叶恺[1] 宗根林[2] 徐玮[1] 李晨[1] YE Kai;ZONG Gen-lin;XU Wei(Radiology Department,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,P.R.C.)

机构地区：[1]上海中医药大学附属曙光医院放射科,上海市200021 [2]上海市东方医院放射科,上海市200120

出　　处：《中国数字医学》2020年第8期119-122,共4页China Digital Medicine

摘　　要：目的:探讨应用对比增强和弥散加权MRI鉴别转移性黏液性大肠腺癌和肝脏单纯囊肿的临床价值。方法:选择2010年1月至2018年9月在我院就诊的转移性黏液性大肠腺癌患者43例共107个转移病灶作为研究对象,同时抽取经病理证实的单纯肝囊肿患者31例共78个病灶进行对照研究。所有患者均接受对比增强和弥散加权MRI检查。观察2组患者MRI定性和定量分析资料差异。结果:转移组和单纯囊肿组形态、囊间隔、边缘增强、囊内强化、内容物、T2加权相SI、T1加权相SI、DWI相比较差异有统计学意义(P<0.05)。转移组(≥1cm者共56例)和单纯囊肿组(≥1cm者共37例)病变直径无统计学差异(P>0.05);ADC值、病灶肝ADC比、HBP相SI、HBP相病灶肝SI比相比较差异有统计学意义(P<0.05)。边缘强化(OR=6.082,P=0.001)和囊内强化(OR=9.389,P<0.001)是预测转移性黏液性大肠腺癌的显著自变量。结论:对比增强和弥散加权MRI有助于鉴别转移性黏液性大肠腺癌和肝脏单纯囊肿,边缘增强和囊内增强是鉴别诊断转移性黏液性大肠腺癌的独立MRI征象,对≥1 cm的病灶,定量测量有助于进一步鉴别诊断。Objective:To investigate the clinical value of contrast-enhanced and diffusion-weighted MRI in differentiating metastatic mucinous colorectal adenocarcinoma from simple hepatic cyst.Methods:Patients with metastatic mucinous colorectal adenocarcinoma(107 Lesions from 43 patients)received by our hospital from January 2010 to September 2018 are selected as study subjects.At the same time,a total of 78 lesions from 31 patients pathologically confirmed as simple hepatic cyst are selected for the control study.All patients are examined by contrast-enhanced and diffusion-weighted MRI.The differences in the qualitative and quantitative analysis data of MRI of the two groups of patients are observed.Results:There are statistically significant differences in morphology,cyst septum,edge enhancement,enhancement in the cyst,content,weighted phase SI of T2,weighted phase SI of T1 and DWI between the metastatic group and the simple cyst group(P<0.05).There is no significant difference in the diameter of lesion between the metastatic group(the diameter of lesion of 56 patients≥1 cm)and the simple cyst group(the diameter of lesion of 37 patients≥1 cm)(P>0.05).ADC value,ADC ratio of liver with lesion,SI of HBP phase and SI ratio of HBP phase of liver with lesion have statistically significant differences(P<0.05).Edge enhancement(OR=6.082,P=0.001)and enhancement in the cyst(OR=9.389,P<0.001)are significant independent variables for predicting the metastatic mucinous colorectal adenocarcinoma.Conclusion:Contrast-enhanced and diffuse-weighted MRI can help to differentiate metastatic mucinous colorectal adenocarcinoma from simple cyst of the liver.Edge enhancement and enhancement in the cyst are independent MRI signs for the differential diagnosis of metastatic mucinous colorectal adenocarcinoma,and quantitative measurement can help with the further differential diagnosis of lesions whose diameter is equal to or greater than 1 cm.

关 键 词：大肠癌 黏液性腺癌 转移性肝癌 肝囊肿 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤]