多b值DWI成像在肝脏感染性病变诊断的应用

Multi-b-value DWI imaging in the Diagnosis of Liver Infection Disease

目的:探讨多b值DW I序列A DC值测量在肝脏感染性病变诊断及鉴别诊断中的应用价值。方法:回顾性分析23例肝脏病变(肝脓肿11例,肝结核3例,9例肝泡状棘球蚴)行多b值的DWI扫描及常规MRI检查,分别拟合出10个b值ADC10 b图,3个低b值(0s/mm2、50s/mm2、100s/mm2)ADClow图,3个高b值(500s/m m2、750s/mm2、1000s/mm2)ADCh ig h图,并将ADClow与ADCh ig h值之间的差异定义为ADCp e r f值。在病变液化区及边缘带绘制两个相同大小的感兴趣区(ROI),分别计算出ADCl ow、ADCh ig h、ADCp e r f及ADC10 b值,并分析三组肝脏病变在不同b值以及不同区域各个测量参数之间的差异。结果:不典型肝泡型包虫与脓肿之间液化区及边缘带ADC10 b,ADCh ig h值的差异均有统计学意义(P<0.05);结核、脓肿、不典型泡性包虫病边缘带ADC10b、ADCpe r f差异均有统计学意义(P<0.05);而脓肿及泡性包虫病液化区ADCpe r f以及结核及脓肿边缘带ADCh ig h无统计学意义(P>0.05)。肝脏各组病变不同区域的ADClow值差异无统计学意义(P>0.05)。结论:DWI和ADC图分析及ADC值测量可为肝脏感染性病变的诊断及鉴别诊断提供重要的补充信息。

Purpose：To discuss the diagnostic value of the multi-b-value diffusion weighted imaging in the diagnosis of liver tuberculosis,liver abscesses and atypical hydatid disease.Methods：Twentythree cases of liver lesions（11 cases of liver abscess,3 cases of liver tuberculosis,9 cases of liver alveolar hydatid） were undergone conventional MRI and multi-b-value DWI.Ten b-values images were fitted as ADC10b map,three low b-values images（Os/mm2,50s/mm2,100 s/mm2） were fitted as ADClow map,three high b-values（500s/mm2,750s/mm2,1000s/mm2） were fitted as ADChigh map,ADCperf map was defined as the difference between ADClow and ADChigh maps.Two region of interest（ROI） of same size were drawn on the liquefied region and marginal area of the masses.The ADC values of ROIs on ADClow,ADChigh,ADCperfand ADC10b maps were calculated and analyzed.Differences of these values among the three groups of liver disease were compared.Results：The differences of the ADC10b,ADChighvalues between the ROIs in the liquefied region and marginal area of atypical liver hydatid and liver abscess were with statistical significant（P〈0.05）;The differences of ADC10b,ADCperf values between the ROIs in the marginal area of liver tuberculosis,abscesses,atypical liver hydatid were with statistical significant（P〈0.05）;The difference of ADCperf values between the ROIs in the liquefied region of thydatid disease and liver abscesses,and the difference of ADChigh values between the ROIs in marginal area of tuberculosis and abscesses were with no statistical significant（P〉0.05）;The differences of ADClow values were with no statistical significant among ROIs in both area of three lesions（P〉0.05）.Conclusion：Multi-b-value DWI can provide valuable additional information for diagnosis and differentiation of liver tuberculosis,liver abscesses and atypical hydatid disease,especially the measurement of ADC values is of of great value.