磁共振弥散加权成像在肝局灶性病变中价值.docVIP

磁共振弥散加权成像在肝局灶性病变中价值【摘要】目的：探讨磁共振弥散加权成像（diffusionweightedimaging，DWI）对肝脏局灶性病变的诊断价值。方法：对50例肝局灶性病变(其中肝细胞癌14例，肝转移瘤17例、 肝囊肿5例、肝血管瘤11例、局灶性结节增生3例)行MRI平扫、DWI及动态增强扫描。分析各病变的弥散成像的信号特点，并测量正常肝脏和病变的表观弥散系数（apparent diffusion coefficient，ADC值）。结果：肝局灶性病变在DWI上为高信号，随b值的增加信号有不同程度下降；当b值为500 s/mm2时，肝细胞癌、肝转移瘤、肝囊肿、肝血管瘤和局灶性结节增生（FNH）的ADC 值分别为(0.81±0.12) ×10-3 mm2/s、(1.13±0.26)×10-3 mm2/s、(3.07±0.37)×10-3 mm2/s、(2.18±0.30)×10-3 mm2/s、(1.67±0.17) ×10-3 mm2/s。肝内良性病变与恶性病变ADC值之间有统计学差异( P0.05)。结论：依据对肝脏局灶性病变的DWI图像、ADC值及其特点分析，能比较准确地判断肝局灶性病变的良恶性，对肝局灶性病变的诊断及鉴别诊断有一定价值。 【关键词】磁共振成像；弥散加权成像；表观弥散系数；肝脏病变 文章编号：1009-5519（2007）20-3014-03 中图分类号：R445 文献标识码：A The value of diffusion weighted imaging in the diagnosis of focal lesions in liver ZHENG Jian-Gang，XU Jian-xing，GU Yong-jian，et al. （Imaging Center，The Affiliated Wujing Hospital of Jiangsu University，Wujing 213002，China） 【Abstract】Objective：Toinvestigatethe diagnosis and differential diagnosis value of diffusionweightedimaging (DWI ) in focal lesions ofliver.Methods：Routine MR ，dynamic enhanced MR and diffusion weighted images were obtained in 50 patients with focal hepatic lesions(14 hepatocellular carcinomas，17 metastatic tumors，11 hemangiomas，5 cysts，3 focal nodal hyperplasia). All signal character in DWI was analyzed and apparent diffusion coefficient(ADC) values were evaluated with different sequences. Results：All lesions showed high signals and signal intensity was decreased according to the increase ofb value. TheADC value of hepatocellular carcinomas，metastatic tumors，cysts hemangiomas，and focal nodal hyperplasia was (0.81±0.12)×10-3 mm2/s、(1.13±0.26)×10-3 mm2/s、(3.07±0.37)×-3 mm2/s、(2.18±0.30) ×10-3 mm2/s、(1.67±0.17)×10-3 mm2/s respectively when b value was 500；The ADC value was significantly different between benign and m alignant lesions(P0.05).Conclusion：According to DWI，ADC values and their characteristics，The focal lesions of liver can be easily diagnosed and distinguished. DWI improve the accuracy in diagnosing hepatic focal l