3.0T MR DWI在肝脏良、恶性局灶性病变诊断中的初步研究

Primary Study on the Diagnosis Focal Benign and Malignant Lesions in Liver with 3.0T MR-DWI

目的探讨3.0TMR扩散加权成像(DWI)在肝脏良、恶性局灶性病变诊断和鉴别诊断中的价值。资料与方法采用GE 3.0T Signal EXCITE超导型磁共振扫描系统对47例肝脏局灶性病变(57个病灶)行DWI,其中25例良性病变30个病灶,22例恶性病变27个病灶。b值选用0、500、1000s/mm2,测量病灶的表观扩散系数(ADC)值并进行统计学分析。用受试者工作特征(ROC)曲线评价ADC值对肝脏良、恶性病变的诊断价值。结果b值为500s/mm2和1000s/mm2时,良性病变的ADC值分别为(3.12±1.58)×10-3mm2/s、(2.23±1.01)×10-3mm2/s;恶性病变的ADC值分别为(2.01±0.95)×10-3mm2/s、(1.31±0.37)×10-3mm2/s,两者之间差异有统计学意义(P<0.01)。ROC曲线评价ADC值诊断肝脏良、恶性病变的曲线下面积、敏感性、特异性、准确性、阳性预测值、阴性预测值分别为0.799、77.8%、76.6%、77.2%、75.0%、79.3%和0.852、81.5%、90.0%、85.9%、88%、84.3%。结论3.0T MR DWI ADC值在肝脏良、恶性病变的鉴别中具有重要参考价值,且b值为1000s/mm2时所测ADC值较准确。

Objective To evaluate the value of diagnosis and differential diagnosis of liver focal benign and malignant lesions by 3.0T MRI-DWI. Materials and Methods 47 cases of liver focal lesion were examined by 3.0T MRI-DWI, 25 cases （30 lesionS） were benign, 22 case（27 lesions）were malignant. When b value was 500 s/mm^2 or 1000 s/mm^2, Apparent diffusion coefficient were measured and analysed by ROC curve. Results With b = 500 s/mm^2 or 1000 s/mm^2, ADCs in benign lesions were（3.12 ± 1.68）× 10^-3 mm^2/s, （2.23 ± 1.00） × 10^-3 mm^2/s and in malignant lesions were （2.01 ±0.95 ）× 10^-3 mm^2/s, （1.31 ± 0.37） ×10^ -3 mm^2/s respectively. ADCs were significance difference between benign and malignant lesions （ P 〈 0.01 ）. Taking ROC curve, the area under ROC, sensitivity, specialty, accuracy, positive predict value,negative predict value in diagnosis benign and malignant focal lesions was 0. 799,77. 8% ,76.6% ,77.2%, 75.0% ,79.3% and 0. 852,81.5% ,90%, 85.9%, 88% ,84.3% respectively. Conclusion It is significant valuable with ADCs in the diagnosis of focal hepatic lesions by 3.0T MRI-DWI and more accurate when taking b = 1000 s/mm^2.