弥散加权成像鉴别诊断儿童良恶性肝肿瘤  

Diffusion weighted imaging in differential diagnosis of benign and malignant liver tumors in children

作　　者：丁雅玲 曹代荣[2] 马小敏 张杰[1] 黄新发 陈春华[1] DING Yaling;CAO Dairong;MA Xiaomin;ZHANG Jie;HUANG Xinfa;CHEN Chunhua(Department of Radiology,Women and Children's Hospital Affiliated to Xiamen University,Maternal and Child Health Hospital of Xiamen,Xiamen 361003,China;Department of Radiology,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]厦门大学附属妇女儿童医院厦门市妇幼保健院放射科,福建厦门361003 [2]福建医科大学附属第一医院影像科,福建福州350005

出　　处：《中国医学影像技术》2021年第2期250-253,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察弥散加权成像(DWI)鉴别诊断儿童良恶性肝肿瘤的价值。方法回顾性分析32例肝肿瘤患儿资料,经病理和影像征象确诊良性(良性组)、恶性(恶性组)各16例,观察并比较2组肿瘤DWI信号特征、最大ADC值(ADC_(max))、最小ADC值(ADC_(min))和平均ADC值(ADC_(ave));采用受试者工作特征(ROC)曲线分析ADC值鉴别诊断儿童肝脏良恶性肿瘤的效能。结果良性组8例病灶DWI呈T2穿透效应,2例弥散增加,6例中等弥散;恶性组13例病灶DWI呈弥散受限,2例T2穿透效应,1例中等弥散。恶性组81.25%(13/16)DWI呈弥散受限,显著高于良性组(0)(P<0.001)。恶性组肿瘤ADC_(max)、ADC_(min)和ADC_(ave)均小于良性组(P均<0.05)。ROC曲线结果显示,ADC_(max)、ADC_(min)、ADC_(ave)均可用于鉴别儿童良恶性肝肿瘤(P均<0.05),ADC_(min)阈值为1.31×10^(-3)mm^(2)/s时,其鉴别儿童良恶性肝肿瘤的曲线下面积(AUC)最大(0.941)。结论DWI有助于鉴别诊断儿童良恶性肝肿瘤。Objective To investigate the value of diffusion weighted imaging(DWI)in differential diagnosis of benign and malignant liver tumors in children.Methods MRI data of 32 children with liver tumors,including 16 benign tumors(benign group)and 16 malignant tumors(malignant group)confirmed by pathology and imaging signs were retrospectively analyzed.The characteristics of DWI signals were observed and compared,and the_(max)imum ADC value(ADC_(max)),minimum ADC value(ADC_(min)),and_(ave)rage ADC value(ADC_(ave))were measured and compared between groups.ROC curve was used to analyze ADC value for differential diagnosis of benign and malignant liver tumors in children.Results In benign group,DWI showed T2 shine-through in 8 cases,with increased diffusion in 2 cases and intermediate diffusion in 6 cases.In malignant group,13 cases were found with diffusion restriction on DWI,2 cases with T2 shine-through and 1 case of intermediate diffusion.The proportion of diffusion restriction on DWI in malignant group was 81.25%(13/16),significantly higher than that in the benign group(P<0.001).ADC_(max),ADC_(min) and ADC_(ave) of malignant group were all lower than those of benign group(all P<0.05).The results of ROC curve showed that ADC_(max),ADC_(min) and ADC_(ave) could be used to distinguish benign and malignant liver tumors in children(all P<0.05).Taken 1.31×10^(-3)mm^(2)/s as the threshold of ADC_(min),the area under the curve(AUC)of differentiating benign and malignant liver tumors in children was the largest(0.941).Conclusion DWI was helpful to differential diagnosis of benign and malignant liver tumors in children.

关 键 词：肝肿瘤 弥散磁共振成像 儿童 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]