MRI检查及ADC值对肝腺瘤诊断的意义

The diagnostic significance of MRI and ADC for hepatocellular adenoma

目的分析MRI检查及ADC值对肝腺瘤诊断的意义。方法以21例经病理检查证实的肝腺瘤患者为研究对象,观察患者术前和活检诊断结果、MRI表现,计算表观扩散系数(ADC),对比以上检查与病理检查结果。结果 2例患者存在肝硬化表现,1例患者9个病灶,5例2个病灶,15例患者为单个病灶。26个病灶内脂质成分多,8个病灶脂质成分少。术前19例患者确诊为良性肝腺瘤,2例考虑为局灶性结节增生。18例病灶直径<3 cm,10例病灶直径在3~5 cm,6例病灶直径>5 cm。T1WI信号低信号30例,高信号4例;T2WI扫描低信号11例,高信号23例;Gd-DTPA增强扫描,动脉期病灶信号明显强化,门静脉期病灶低信号12例,高信号22例;延迟期扫描病灶低信号12例,高信号22例;DWI扫描病灶低信号21例,高信号13例。可见假包膜样强化病灶14例,假包膜样强化未明确20例。34例病灶平均ADC值为(1.704±0.330)×10^(-3)mm^2/s,病灶周边正常肝实质ADC值为(1.357±0.214)×10^(-3)mm^2/s,病灶ADC值与病灶周边肝实质ADC值比值>1。结论 MRI检查联合病灶ADC值测量可为诊断肝腺瘤提供更为准确的参考依据,提高临床诊断肝腺瘤的准确率。

Objective To analyze the diagnostic significance of magnetic resonance imaging（MRI）and apparent diffusion coefficient（ADC）for hepatic adenoma.Methods Twenty-one cases pathologically confirmed as hepatic adenoma were enrolled for comparison analysis between preoperative biopsy,MRI performance and ADC.Results Among the 21 cases,19 and 2 cases were preoperatively diagnosed as benign liver adenomas and focal nodular hyperplasia,respectively;2 cases were accompanied with cirrhosis;1,5 and 15 cases had 9,2 and single lesions,respectively.In terms of the 34 lesions,26 had high lipid content,while 8 had low lipid content.Additionally,there were 18 lesions with less than 3cm in diameter,10 with 3-5cm and 6 with more than 5cm.The T1WI scan signals were low in 30 lesions and high in 4,and the T2WI scan signals were low in 11 lesions and high in 23.Gd-DTPA enhanced scan showed that the signals were significantly strengthened during the arterial phase,were low in 12 lesions and high in 22 during the portal venous phase,and were low in 12 lesions and high in 22 in the delayed phase.Moreover,diffusion weighted imaging（DWI）scan showed that the signals were low in 21 lesions and high in 13.Pseudocapsule-like enhancing lesions were observed in 14 lesions,and the other 20 ones displayed as no clear signs.The ratio of mean ADC value of 34 lesions to the value of their surrounding normal liver parenchyma was more than 1 [（1.704±0.33）×10^-3mm^2/s vs.（1.357±0.214）×10^-3mm^2/s].Conclusion MRI combined with ADC value measurements could provide reliable references for the diagnosis of hepatic adenoma and improve the accuracy of clinical diagnosis.