SWI成像对肝细胞癌和肝血管瘤的鉴别诊断价值

Differential diagnostic value of two dimensional multi-breath-hold susceptibility weighted imaging for hepatocellular carcinoma and hepatic hemangioma

目的探讨磁敏感加权成像(susceptibility weighted imaging,SWI)对肝细胞癌和肝血管瘤的检出和鉴别效能。方法2012年1月至2月进行SWI序列检查的肝细胞癌患者41例共51个病灶;血管瘤患者13例共23个病灶纳入本次研究。2位资深读片者分别阅读SWI图像并测量病灶和邻近肝实质在SWI上的信号强度和标准差,根据公式计算病灶的信噪比(signal noiseratio,SNR),病灶信号相对肝脏信号的对噪比(contrast noise ratio,CNR)。比较SWI序列对两种病灶之间检出率及SNR、CNR值的差异。结果 SWI序列对肝细胞癌和血管瘤检出率之间的差异无统计学意义。肝血管瘤的SNR、CNR值在SWI序列高于肝细胞癌,差异有统计学意义(P<0.05)。结论 SWI对肝细胞癌和血管瘤的检出和鉴别诊断有辅助意义。

Objective To compare the efficacy of susceptibility weighted imaging （SWI） in detection and differentiation of hepatocellular carcinoma and hemangioma. Methods The data of 41 patients with 51 hepatocellular carcinoma lesions and 13 patients with 23 hemangioma lesions during Jan to Feb, 2012 were selected. All patients underwent MR including SWI in the study. Two radiologists interpreted SWI images and measured the signal intensity （SI） of the lesions, adjacent liver parenchyma SI and standard deviation （Sd）, while the signal noise ratio （SNR） and the contrast noise ratio （CNR） were calculated. The detecting rates of the lesions and the mean SNR and CNR were compared between the two diseases. Results There were no significant difference in the detecting rate of hemangioma and hepatocellular carcinoma by SWI. The SNR and CNR of hemangioma were higher than those of hepatocellular carcinoma on DWI （ P 〈 0. 05 ）, and there was a significant difference between the two diseases as for the SNR and CNR. Conclusion SWI is valuable in diagnosis and differential diagnosis of hepatocellular carcinoma and hemangioma.