弥散加权MRI及ADC值鉴别良恶性胆囊息肉样病变的诊断价值  

Diagnostic Value of Diffusion Weighted MRI and ADC in Differentiating Benign and Malignant Polypoid Lesions of Gallbladder

作　　者：张灿[1] 余成新[1] 刘亚娟[2] Zhang Can;Yu Chengxin;Liu Yajuan(Department of Radiology,Yichang Central People’s Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China;Department of Ultrasound,Yichang Central People’s Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]放射科,湖北宜昌443003 [2]三峡大学第一临床医学院[宜昌市中心人民医院]超声科,湖北宜昌443003

出　　处：《巴楚医学》2022年第3期63-68,共6页Bachu Medical Journal

基　　金：湖北省自然科学基金项目(No:2015CFC853)。

摘　　要：目的:探讨弥散加权MRI及表观弥散系数(ADC)值对良恶性胆囊息肉样病变(PLGs)的鉴别诊断价值。方法:收集我院手术治疗的44例PLGs(均经病理证实),其中良性PLGs 24例,恶性PLGs 20例,术前均接受常规MRI及弥散加权成像(DWI)扫描。DWI图像按信号强度被分为等信[JP2]号、高信号和很高信号三级,然后重建病变ADC图像并测量其ADC值。结果:b值=800 s/mm^(2)[JP]的DWI信号显示,良性PLGs中20例呈等信号,4例呈高信号;恶性PLGs中14例呈很高信号,6例呈高信号。恶性PLGs的DWI信号强度明显高于良性PLGs,两组之间的差异有显著统计学意义(P<0.001);而其平均ADC值[(1.12±0.23)×10^(-3)mm^(2)/s]显著低于良性PLGs[(1.85±0.22)×10^(-3)mm^(2)/s],两组之间的差异有显著统计学意义(P<0.001)。取ADC诊断阈值1.52×10^(-3)mm^(2)/s,诊断恶性PLGs的敏感度、特异度和准确度分别为90.00%、100.00%和95.45%。结论:DWI及ADC值测量可明显提高良恶性PLGs(直径≥0.5 cm)的诊断准确性。Objective:To investigate the value of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)in the differential diagnosis of benign and malignant polypoid lesions of gallbladder(PLGs).Methods:A total of forty-four cases of PLGs(all confirmed by pathology)treated in our hospital were collected,including 24 cases of benign PLGs and 20 cases of malignant PLGs.All patients underwent routine MRI and DWI scanning before operation.DWI images were divided into equal signal,high signal and very high signal levels according to signal intensity,and then the lesion ADC image was reconstructed and its ADC value was measured.Results:At b value=800 s/mm 2,DWI signal intensity showed that 20 benign PLGs were isointense,and 4 were hyperintense.Among 20 cases of malignant PLGs,there were 14 cases performed with very high signal intensity and 6 cases with high signal intensity.Compared to the benign PLGs,DWI signal intensity of malignant PLGs was significantly higher,the average ADC value[(1.12±0.23)×10^(-3) mm^(2/)s VS(1.85±0.22)×10^(-3) mm^(2)/s]was significantly lower,with statistically significant differences(both P<0.001).At diagnostic threshold of 1.52×10^(-3 )mm^(2)/s,the sensitivity,specificity and accuracy of diagnosing malignant PLGs were 90.00%,100.00%and 95.45%,respectively.Conclusion:DWI and ADC value measurement can improve the diagnosis accuracy of benign and malignant PLGs(diameter≥0.5 cm).

关 键 词：胆囊息肉样病变 弥散加权成像 表观弥散系数 

分 类 号：R735.8[医药卫生—肿瘤]