扩散加权平面回波成像在肝占位性病变中的应用探讨

Diffusion weighted echo planar imaging:applications in evaluation of hepatic masses

目的 探讨扩散加权平面回波成像在肝占位性病变中的应用，以及表面扩散系数（ＡＤＣ）评估肝占位病变的价值。方法 对４８ 例共有５８ 个肝占位病灶患者进行了扩散加权平面回波成像。５８ 个肝占位病灶中肝癌３０ 个，肝血管瘤１６ 个，肝囊肿１２ 个。应用不同梯度因子ｂ 值的扩散图像拟合出ＡＤＣ图，并获取ＡＤＣ值。结果 肝癌、肝血管瘤和肝囊肿的平均ＡＤＣ 值分别为：（１－２５±０－５１）×１０－ ３ ｍｍ２／ｓ、（１－７５ ±０－６０） ×１０－３ ｍｍ２／ｓ 和（３－１５ ±０－４３） ×１０－３ ｍｍ２／ｓ，三者存在着显著性差异（Ｐ＜０－０１） 。结论 扩散加权平面回波成像对肝癌、肝血管瘤和肝囊肿的鉴别诊断具有一定的价值，但不适宜对小病灶作定性诊断。

Objective To evaluate the application of diffusion weighted echo planar imaging(EPI) and apparent diffusion coefficient(ADC) in hepatic masses Methods Forty eight patients with 58 liver masses had diffusion weighted EPI Among the 58 cases, 30 were hepatomas, 16 hemangiomas,and 12 hepatic cysts Multi diffusion weighted images with different b values were integrated to ADC map, and the average ADC values were obtained Results Average ADC values of hepatoma, liver hemangioma and liver cysts were (1 25±0 51)×10 -3 、(1 75±0 6)×10 -3 , and (3 15±0 43)×10 -3 mm 2/s, respectively The difference between the average ADC values was significant ( P <0 01) Conclusion Diffusion weighted EPI is useful in differentiation among hepatoma, liver hemangioma and liver cysts It is, however, difficult to detect or identify small liver lesions with diffusion weighted EPI