多b值DWI序列ADC值联合肿瘤标志物检测对肝脏良恶性肿瘤诊断中的临床价值

Clinical Value of Multi-b Value DWI Sequence ADC Value Combined with Tumor Markers Detection in the Diagnosis of Benign and Malignant Liver Tumors

目的研究多b值扩散加权成像(DWI)序列表观扩散系数(ADC)值联合肿瘤标志物检测对肝脏良恶性肿瘤诊断中的临床价值。方法收集2015年1月至2018年6月于医院接受治疗的肝脏占位性病变患者54例,肝癌10个病灶、肝转移瘤16个病灶、肝血管瘤10个病灶、肝囊肿16个病灶,使用肝多b值的DWI扫描及常规MIR检查,分别计算ADClow、ADChigh、ADCperf、ADC3b、ADC10b值,分析肝脏良、恶肿瘤各ADC值之间的差异,检测肿瘤标志物甲胎蛋白(AFP)、癌胚抗原(CEA)、癌抗原199(CA-199)、癌抗原125(CA-125)在肝脏良恶性肿瘤患者血清中的含量;采用不同方法诊断,A法为常规DWI扫描诊断;B法为b值扩散加权成像序列表观扩散系数值联合肿瘤标志物检测,比较两种方法的诊断率。结果相比良性组,恶性组ADC3b、ADC10b、ADChigh的ADC值均低于良性组;恶性组ADCperf值高于良性组,且两者相比差异有统计学意义(P<0.01);两组ADClow值无显著性差异(P>0.05);相比良性组,恶性组患者血清内AFP、CEA、CA-199、CA-125含量显著升高,且两者相比差异有统计学意义(P<0.01);多b值DWI序列ADC值联合肿瘤标志物检测可以显著提高肝癌的诊断率(P<0.01)。结论ADC10b、ADChigh、ADC3b、ADCperf值对肝脏良恶性肿瘤诊断有显著优势,与肿瘤标志物联合应用有助于鉴别肝脏良恶性肿瘤,多b值DWI序列ADC值联合肿瘤标志物检测有助于提高肝癌的诊断率。

Objective To study the clinical value of multi-b value diffusion-weighted imaging(DWI)sequence apparent diffusion coefficient(ADC)value combined with tumor markers detection in the diagnosis of benign and malignant liver tumors.Methods A total of 54 patients with liver space-occupying lesions who were treated in the hospital from January 2015 to June 2018 were selected,including 10 lesions of liver cancer,16 lesions of liver metastases,10 lesions of hepatic hemangioma and 16 lesions of hepatic cysts.The liver multi-b value DWI scan and routine MRI examination were performed,and the ADClow,ADChigh,ADCperf,ADC3b and ADC10b values were calculated,and the differences of ADC values were analyzed between benign and malignant tumors.The contents of tumor markers of alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),cancer antigen 199(CA-199)and cancer antigen 125(CA-125)in the serum were detected in patients with benign and malignant liver tumors.Different methods were given for diagnosis,and method A was conventional DWI scan diagnosis,and method B was b-value diffusion-weighted imaging sequence apparent diffusion coefficient value combined with tumor markers detection,and the diagnostic rates of the two methods were compared.Results Compared with benign group,the ADC values of ADC3b,ADC10b and ADChigh in malignant group were lower than those in benign group.The ADCperf value in malignant group was higher than that in benign group(P<0.01).There was no significant difference in the ADClow value between the two groups(P>0.05).Compared with benign group,the contents of AFP,CEA,CA-199 and CA-125 in the serum were significantly increased in malignant group(P<0.01).Multi-b value DWI sequence ADC value combined with tumor markers detection could significantly improve the diagnosis rate of liver cancer(P<0.01).Conclusion ADC10b,ADChigh,ADC3b and ADCperf have significant advantages in the diagnosis of benign and malignant liver tumors.Tumor markers can be combined to distinguish between benign and malignant liver tumors.Multi-b value DWI sequence ADC value combined with tumor markers detection can improve the diagnosis rate of liver cancer.