磁共振动态增强扫描联合扩散加权成像在肝局灶性病变诊断中的应用价值

Application of Dynamic Enhanced Magnetic Resonance Imaging Combined with Diffusion Weighted Imaging in the Diagnosis of Focal Liver Lesions

目的分析磁共振动态增强扫描(DCE-MRI)联合扩散加权成像(DWI)检查在肝局灶性病变(FLLs)诊断中的应用价值。方法选取2019年4月至2020年12月南阳张仲景医院收治的87例FLLs患者作为研究对象。患者均接受DCE-MRI扫描、DWI扫描检查。分析扩散敏感系数(b值)为500 s·mm^(-2)时不同病变表观弥散系数值(ADC)及不同病变DCE-MRI参数[正性增强积分(PEI)、最大下降斜率(MSD)、最大上升斜率(MSI)、信号增强率(SER)、峰值(PV)],并比较DCE-MRI检查、DCE-MRI联合DWI检查对肝血管瘤、原发性肝癌、肝转移癌的检出率。结果b值为500 s·mm^(-2)时,肝血管瘤ADC值大于原发性肝癌及肝转移癌,且肝血管瘤患者PEI、MSD、MSI、PV均大于原发性肝癌及肝转移癌患者(P<0.05);DCE-MRI联合DWI检查原发性肝癌、肝血管瘤、肝转移癌检出率(95.83%、100.00%、93.33%)均高于DCE-MRI(72.92%、75.00%、53.33%)(P<0.05)。结论应用DCE-MRI联合DWI诊断FLLs,能有效反映病变性质,提高不同病变检出率,有利于临床早期明确病情,制定综合、合理治疗方案。

Objective To analyze the application value of dynamic enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion weighted imaging(DWI)in the diagnosis of focal liver lesions(FLLs).Methods A total of 87 patients with FLLs who were treated in Nanyang Zhangzhongjing Hospital from April 2019 to December 2020 were selected.All of them accepted DCE-MRI scan and DWI scan.Analyzed the apparent diffusion coefficient(ADC)of different lesions and the DCE-MRI parameters of different lesions when the diffusion sensitivity coefficient(b value)is 500 s·mm^(-2)[positive enhancement integral(PEI),maximum slope of decrease(MSD),maximum slope of increase(MSI),signal enhancement rate(SER),peak value(PV)],and compare the detection rates of hepatic hemangioma,primary liver cancer and liver metastasis by DCE-MRI,DCE-MRI and DWI.Results When b was 500 s·mm^(-2),the ADC value of liver hemangioma was greater than that of primary liver cancer and liver metastases,and the PEI,MSD,MSI and PV of patients with liver hemangioma were more than those of patients with primary liver cancer and liver metastases(P<0.05).The detection rates of primary liver cancer,liver hemangioma and liver metastasis by DCE-MRI and DWI(95.83%,100%,93.33%)were higher than those detected by DCE-MRI(72.92%,75.00%,53.33%)(P<0.05).Conclusion The use of DCE-MRI combined with DWI to diagnose FLLs can effectively reflect the nature of the lesions and increase the detection rate of different lesions,which is beneficial to the early clinical diagnosis of the disease and the formulation of a comprehensive and reasonable treatment plan.