磁共振扩散加权成像在胆管癌及肝占位性病变鉴别诊断中的应用价值

Application value of DWI in the differentiation of cancer from lesions in the liver bile duct

目的探讨磁共振扩散加权成像在胆管癌及肝良、恶性占位性病变鉴别诊断中的应用价值。方法采用DWI技术对胆管癌患者及肝良、恶性占位性病变患者进行了鉴别和诊断,探讨DWI对胆管癌定性诊断中的作用,及其与肝其他占位性病变进行鉴别比较研究过程中的特点。结果肝细胞癌组、肝转移瘤组的ADC值与胆管癌组比较无明显差异。肝血管瘤组、肝囊肿组及正常肝组织的ADC值则明显高于胆管癌组,且差异具有统计学意义。胆管癌组的ADC值与与肝恶性病变比较无明显差异;但是胆管癌组的ADC值明显低于肝良性病变组,且差异具有统计学意义。结论DWI序列速度快,通过DWI图像特点及量化分析ADC值,对胆管癌及肝良、恶性占位性病变可提供定量的诊断信息,可作为上腹部平扫的补充检查序列,应列为MRI常规序列之一。

Objective To study the value of diffusion weighted imaging （DWI） in the differentiation of benign and malignant bile duct carcinoma and liver space-occupying lesions. Methods Using DWI technique, we tried to differentiate the bile duct carcinoma, benign or malignant liver space-occupying lesions in patients with liver disorders, to explore the role of DWI in qualitative diagnosis of bile duct carcinoma and the other space-occupying lesions in the liver, and to identify the characteristics of other diseases. Results ADC values of hepatocellular carcinoma （HCC）, liver metastases, and bile duct cancer were no significant difference. However, the ADC values of liver hemangioma, liver cyst and normal liver tissue were statistically significant higher than that of bile duct carcinoma. ADC values of duct carcinoma were no significant difference compared with these of malignant lesions, whereas, ADC values of the bile duct carcinoma were markedly lower, with statistically significant difference. Conclusion DWI sequence, which has high speed, can differentiate the benign, malignant bile duct carcinoma, and liver space-occupying lesions via image characteristics and the quantitative analysis of ADC value. Therefore, DWI can provide quantitative diagnostic information and can be used as a supplement for the upper abdomen scan check sequence, which should be taken as one of routine MRI sequences.