肝脏结节性病变的多B值扩散加权成像诊断

Diagnosis of Multi B-value Diffusion Weighted Imaging in Hepatic Nodular Lesions

目的探讨多B值DWI双指数函数模式参数在肝脏结节性病变中的诊断与鉴别诊断的价值。方法对62例经手术病理或其他方式证实的肝脏结节性病变,其中肝囊肿13例,海绵状血管瘤8例,原发性肝癌23例,转移性肝癌18例,行多B值DWI扫描,B值取0、100、200、400、800、1000、1200s/mm^2,测量standard ADC值、单指数函数Slow ADC-Mono、Fast ADC-Mono和双指数函数Slow ADC-Bi、Fast ADC-Bi的定量值,相关数据行统计学分析。结果单因素方差分析,除standard ADC外,Slow ADC-Mono、Fast ADC-Mono、Slow ADC-Bi、Fast ADC-Bi定量值在肝脏结节性病变及正常组织间比较差异均有统计学意义。LSD两两比较,Slow ADC-Mono在正常组织与结节性病变间比较差异均有统计学意义,在血管瘤与囊肿、囊肿与原发性肝癌、转移性肝癌间比较差异有统计学意义,而血管瘤与原发性肝癌、转移性肝癌间及原发性肝癌与转移性肝癌间比较差异无统计学意义。Fast ADC-Mono在正常组织与囊肿、血管瘤与原发性肝癌、转移性肝癌间及囊肿与原发性肝癌、转移性肝癌间比较差异有统计学意义。Slow ADC-Bi在正常组织、各结节性病变间比较差异均有统计学意义。Fast ADC-Bi在正常组织与原发性肝癌、转移性肝癌间、血管瘤与原发性肝癌、转移性肝癌间、囊肿与原发性肝癌、转移性肝癌间比较差异有统计学意义,其余差异无统计学意义。结论双指数函数模式的Slow ADC-Bi和Fast ADC-Bi参数在一定程度上反映了肝脏结节性病变的ADC特征,并对其诊断与鉴别诊断具有一定意义。

Objective To investigate the value of multi B -value DWI double exponential function model in diagnosis and differenti- al diagnosis of hepatic nodular lesions.Methods Totally 62 cases of hepatic nodules (13 cases of hepatic cyst,8eases of cavernous hemangioma,23cases of hcpatocellular carcinoma and 18cases of metastatic hepatoeellular carcinoma)which confirmed by surgery pathology or other methods,were scanned by multi B value DWI of MRI sequence,the B values were set as 0,100,200,400,800,1000, 1200s/mm2.The quantitative values of standard ADC,single exponential function (Slow ADC -Mono,Fast ADC -Mono)and double exponential function (Slow ADC -Bi,Fast ADC -Bi)were measured,and related data were statistical analyzed.Results Used by single factor analysis of variance,except for standard ADC,the quantitative values of slow ADC -mono,fast ADC -mono,slow ADC -bi,fast ADC -bi in the liver nodular lesions and normal tissues differed significantly in statistics.By contrast of LSD test,slow ADC -mono had statistical differences between normal tissue and nodular lesions,hemangioma and cyst,cyst and primary liver cancer and metastatic liver cancer.However,the statistical difference between hemangioma and primary liver cancer and metastatic liver cancer,between primary liver cancer and metastatic liver cancer was not found.Fast ADC -mono had statistical differences between normal tissue and cyst,hemangioma and primary liver cancer and metastatic liver cancer,cyst and primary liver cancer and metastatic liver cancer.Slow ADC -Bi in normal tissue and each nodular lesions were statistically different.Fast ADC -Bi had statistical differences between normal tissues and primary liver cancer and metastatic liver cancer,hemangioma and primary liver cancer and metastatic liver cancer,cyst and primary fiver cancer and metastatic liver cancer,but the statistical differences of the rest was't found.Conclusion The slow ADC -Bi and fast ADC -Bi parameters of the double exponential function model in certain degree reflect the ADC features of hepatic nodular lesions,and have certain significance in diagnosis and differential diagnosis.