磁共振扩散加权成像对肝脏常见肿瘤的诊断及鉴别诊断作用

The application of MR DWI in the diagnosis and differential diagnosis of common liver masses

目的:探讨磁共振扩散加权成像对肝脏常见肿瘤的诊断及鉴别诊断的作用。方法:选取肝脏常见肿瘤88例,其中原发性肝癌28例,肝转移瘤15例,肝血管瘤33例,肝囊肿12例。行轴位扩散加权扫描,并拟合出ADC图,在ADC图上测出ADC值并进行统计分析。然后行动态增强全肝扫描,观察实性病变在动脉期、门脉期以及延迟期不同时相的强化程度。结果:肝囊肿和血管瘤ADC值均明显高于原发性肝癌、转移瘤(P<0.01),根据多期动态增强扫描动脉期肝脏恶性肿瘤病灶的表现将其分为富血供病灶和乏血供病灶。结论:ADC值的应用大大提高了MRI对肝脏常见肿瘤的诊断和鉴别诊断能力。

Objective： To evaluate the efficacy of DWI for diagnosis and differentiation of common liver masses. Methods： DWI was performed in 88 patients having hepatic lesions, including primary hepatic carcinoma（n=28）, hepatic metastases（n=15）, hepatic cavernous hemangioma（n=33） and hepatic cyst （n=12）. The apparent diffusion coefficient（ADC） values of these lesions were measured, then statistical analysis was performed. Muhiphase dynamic enhancement was performed to observe dynamic contrast-enhanced changes in arterial, portal and delay phase of these lesions. Result： The ADC values of hepatic cysts and hemangiomas were higher than those of primary hepatic carcinomas and hepatic metastasis, which were significantly different （P〈0.01）. According to signal intensity in arterial phase, hepatic malignant tumors were classified into hypervascular and hypovascular lesions. Conclusion： The measurement of ADC values is helpful in MR diagnosis and differentiation of common liver masses.