背景抑制体部磁共振弥散加权成像在肝内局灶性病变诊断方面的应用价值研究

胡奕; 郭启勇

中国临床医学影像杂志 ›› 2006, Vol. 17 ›› Issue (10) : 547-550.

论著

背景抑制体部磁共振弥散加权成像在肝内局灶性病变诊断方面的应用价值研究

胡奕,郭启勇

作者信息 +

MR diffusion weighted imaging with background suppressionin the diagnosis and differential diagnosis of focal hepatic lesions

HU Yi, GUO Qi-yong

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摘要

目的:评价背景抑制磁共振弥散加权成像在肝脏局灶性病变诊断中的应用价值。材料与方法:将60例病人的89个肝脏局灶病变作为研究对象,包括28处肝转移瘤,32处原发性肝癌,8个血管瘤,17个肝囊肿,胆源性肝脓肿2处以及局灶性结节增生1处,胆管腺癌1处。行背景抑制磁共振弥散加权成像后,计测并比较肝内各种病变的ADC值;对部分病人行全身多部位大范围扫描,查找远隔病变。结果:①肝内良性病变ADC值明显高于恶性病变(P<0.05),以1.6×10^-3mm²/s作为良恶性病变ADC值的界限,敏感度和特异度均>90%。②原发性肝癌、转移瘤、血管瘤及肝囊肿的ADC值呈递增趋势。③血管瘤、转移瘤及原发性肝癌与肝脏的比值依次递增(P<0.05)。④对部分病人行大范围扫描后可以查找出原发灶或远隔器官病变。结论:背景抑制磁共振弥散加权成像在肝脏占位病变的诊断方面有较高的临床应用价值。

Abstract

Objective: To study the value of MR diffusion weighted imaging with background suppression(DWIBS) in the diagnosis and differential diagnosis of focal hepatic lesions. Materials and Methods: Eighty-nine focal hepatic lesions of 60 patients were brought into study, including 28 hepatic metastases, 32 hepatic cellular carcinomas(HCC), 8 hemangiomas, 17 hepatic cysts, 2 hepatic abscesses, 1 focal nodular hyperplasia and 1 biliary adenocarcinoma. Values of apparent diffusion coefficients(ADCs) were calculated and compared. To find remote lesions, large-scale DWIBS with 3D-MIP reconstruction was performed on several patients. Results: ADC values of benign lesions were higher than those of malignant ones(P<0.05) and 1.6×10^-3mm²/s can be set as the criteria for benign lesions versus malignancy with both sensitivity and specificity higher than 90%. ADC decreased in HCC and metastasis, while that of hemangioma and hepatic cyst increased in turn. The ADClesion/ADCliver ratio can be used to differentiate HCC, metastasis and hemangioma(P<0.05). Remote lesions were found on some patients by large-scale scanning, which can confirm the diagnoses of metastasis. Conclusion: MR DWIBS may be a useful tool for diagnosis and differential diagnosis of focal hepatic lesions.

导出引用

胡奕;郭启勇. 背景抑制体部磁共振弥散加权成像在肝内局灶性病变诊断方面的应用价值研究[J]. 中国临床医学影像杂志. 2006, 17(10): 547-550

HU Yi;GUO Qi-yong. MR diffusion weighted imaging with background suppressionin the diagnosis and differential diagnosis of focal hepatic lesions[J]. Journal of China Clinic Medical Imaging. 2006, 17(10): 547-550

中图分类号： R735.7 R445.2