磁共振增强成像联合DWI在不典型肝脓肿及肝脏转移瘤诊断中的应用

Application of contrast-enhanced MRI combined with DWI in the diagnosis of atypical hepatic abscess and hepatic metastatic tumor

目的探讨磁共振增强成像(contrast-enhanced magnetic resonance imaging,CEMRI)联合扩散加权成像(diffusion weighted imaging,DWI)在不典型肝脓肿及肝脏转移瘤诊断中的诊断价值。材料与方法回顾性分析滨州市人民医院2019年1~12月最终入组的12例不典型肝脓肿、11例肝脏转移瘤共43个病灶,均有MRI平扫、DWI序列、CEMRI检查,所有病例均由病理学或临床随访证实。分为CE-MRI和CE-MRI联合DWI两组,对病灶的信号特征、强化方式进行分析比较;对所测得的不典型肝脓肿和肝脏转移瘤的囊、实性区的扩散加权成像的ADC值进行比较。结果CE-MRI诊断不典型肝脓肿、肝脏转移瘤的准确率分别为68.42%、66.67%,CE-MRI联合DWI诊断不典型肝脓肿、肝脏转移瘤的准确率分别为94.73%、87.50%,均高于CE-MRI单独诊断。不典型肝脓肿、肝脏转移瘤囊性成分ADC值分别为(1.18±0.04)×10^-3 mm^2/s、(2.02±0.17)×10^-3 mm^2/s,差异有统计学意义(P<0.01);不典型肝脓肿、肝脏转移瘤的实性成分ADC值分别为(1.58±0.10)×10^-3 mm^2/s、(0.91±0.10)×10^-3 mm^2/s,差异有统计学意义(P<0.01)。结论CE-MRI联合DWI在不典型肝脓肿、肝脏转移瘤的鉴别诊断方面更加有优势。

Objective:To investigate the diagnostic value of contrast-enhanced magnetic resonance imaging(CE-MRI)combined with diffusion weighted imaging(DWI)in the diagnosis of atypical liver abscess and liver metastases.Materials and Methods:Retrospective analysis from January to December 2019 in Binzhou People's Hospital,12 cases of atypical liver abscess and 11 cases of liver metastatic tumor were finally enrolled into the group,with a total of 43 lesions,MRI plain scan,DWI sequence and MR enhanced scan were performed in all cases,and all cases were confirmed by histological or clinical follow-up.It was divided into two groups,CE-MRI and CE-MRI combined with DWI,and the signal characteristics and enhancement modes of the lesions were analyzed and compared.Apparent diffusion coefficient(ADC)values of cystic and solid components of atypical liver abscess and metastatic tumor were compared.Results:The accuracy of CE-MRI in the diagnosis of atypical liver abscess and liver metastasis was 68.42%and 66.67%,respectively,and the accuracy of CE-MRI combined with DWI in the diagnosis of atypical liver abscess and liver metastasis was 94.73%and 87.50%,respectively,which were both higher than that of CE-MRI alone.The ADC values of cystic components of atypical liver abscess and liver metastatic tumor were about(1.18±0.04)×10^-3 mm^2/s,(2.02±0.17)×10^-3 mm^2/s,P<0.01,showing statistical differences;The ADC values of solid components of liver abscess and liver metastasis were approximately(1.58±0.10)×10^-3 mm^2/s,(0.91±0.10)×10^-3 mm^2/s,P<0.01,with statistical differences.Conclusions:CE-MRI combined with DWI has more advantages in the diagnosis of atypical liver abscess and liver metastases.