3.0T磁共振弥散成像对肝脏恶性局灶性病变诊断的价值

Diffusion-weighted images on focal malignant hepatic lesions at 3 Tesla magnetic resonance

目的:探讨3.0 Tesla磁共振弥散成像(DWI)对肝脏3种恶性局灶性病变的价值。方法:对47例肝脏恶性局灶性病变进行磁共振弥散加权散成像,分析各种病变弥散成像的特点并测量肝脏和病变的表观弥散系数(ADC值)。结果:DWI图像显示,病灶呈较高信号46例,信号欠均匀以及边界欠清的病灶分别占51.06%(24/47)4、4.68%(21/47)。当b值为400 s/mm2时,肝细胞癌、胆管细胞癌和转移瘤的ADC值分别为[(145.86±33.97)×10-3]mm2/s、[(185±53.09)×10-3]mm2/s和[(212.62±81.72)×10-3]mm2/s,转移瘤与肝脏的ADC值存在显著的差异(t=3.202,P=0.011),肝细胞癌和胆管细胞癌与肝脏的ADC值之间无差异。转移瘤与肝细胞癌之间、肝细胞癌与胆管细胞癌之间的ADC值差异均具有统计学意义(P<0.05),转移瘤与胆管细胞癌的ADC值差异无统计学意义。结论:3.0 Tesla MR弥散成像有助于肝细胞癌、胆管细胞癌和转移瘤的诊断及鉴别。

Objective： To investigate the 3.0 Tesla magnetic resonance diffusion-weighted imagos on focal malignant hepatic lesions. Methods： Magnetic resonance diffusion-weighted imaging （DWI） was obtained in a total of 47 cases of focal malignant hepatic lesions including hepatocellular carcinoma （HCC）, cholangiocellular carcinoma （CCC） and secondary tumors of liver pathologically. The characteristics of the DWI and apparent diffusion coefficient （ADC） values were analyzed. Results： The lesions with hyperintensity, heterogeneity or indistinct rim were in 46, 24, or 21 on DWI imagos, respectively. The ADC value of the HCC, CCC or secondary tumors of liver was （145.86 ± 33.97） × 10^-3 mm^2/s, （185 ± 53.09） × 10^-3 mm^2/s or （212.62 ± 81.72）× 10^-3 mm^2/s, respectively. There was a significant difference between liver tissue and the secondary tumor （ t = 3. 202, P = 0.011 ）, and the ADC value was higher in HCC than that in CCC or in the secondary tumor （ P 〈 0.05 ）. Conclusion： DWI at 3.0 Tesla MR is conductive to accurate diagnosis of malignant lesions.