3.0T磁共振扩散加权成像与超声造影诊断直径≤3cm肝脏占位性病变价值比较

Comparison on the Diagnostic Value of 3.0T Magnetic Resonance Diffusion-Weighted Imaging and Contrast-Enhanced Ultrasound in Hepatic Occupying Lesions Not Longer than 3cm

目的探讨3.0T磁共振扩散加权成像(DWI)与超声造影(CEUS)诊断直径≤3cm肝脏占位性病变的价值。方法回顾性分析2016年3月至2020年3月医院收治的82例直径≤3cm肝脏占位性病变患者的临床资料,分析CEUS、DWI对直径≤3cm肝脏占位性病变患者的诊断价值。结果82例肝脏占位性病变患者,其中良性病灶45例,恶性病灶37例。所有患者经CEUS、DWI检查后,将评估结果与病理及临床诊断结果进行比较,CEUS诊断准确率为91.46%(75/82)高于DWI的90.24%(74/82),差异无统计学意义(P>0.05)。CEUS检查的敏感性和特异性分别为89.18%、93.33%与DWI检查的97.30%、84.44%,比较差异无统计学意义(P>0.05)。结论3.0T磁共振DWI和CEUS在直径≤3cm肝脏占位性病变患者的诊断中均具有较高准确性,DWI对肝脏病变的组织学特性反映更直观,CEUS可以实时对病灶血流灌注过程进行评估,若患者在DWI和CEUS表现均不典型,需要联合既往病史、实验室检查资料综合判断,必要时进行穿刺活检。

Objective To explore the diagnostic value of 3.0T magnetic resonance diffusion-weighted imaging(DWI)and contrast-enhanced ultrasound(CEUS)in hepatic occupying lesions not longer than 3cm.Methods The clinical data of 82 patients with hepatic occupying lesions not longer than 3cm who were admitted to the hospital from March 2016 to March 2020 were retrospectively analyzed.The diagnostic value of CEUS and DWI in patients with hepatic occupying lesions not longer than 3cm was analyzed.Results Of the 82 patients with hepatic occupying lesions,45 cases with benign lesions,and 37 cases with malignant lesions.After CEUS and DWI examination,the evaluation results were compared with results of pathology and clinical diagnosis.The diagnostic accuracy of CEUS was higher than that of DWI[91.46%(75/82)vs.90.24%(74/82)](P>0.05).There were no significant differences in sensitivity and specificity between CEUS and DWI(89.18%,93.33%vs.97.30%,84.44%)(P>0.05).Conclusion The diagnostic accuracy of both 3.0T magnetic resonance DWI and CEUS is high in patients with hepatic occupying lesions not longer than 3cm.DWI can more intuitively reflect histological features of hepatic lesions,while CEUS can evaluate the blood perfusion of lesions in real-time.If patients'performances in either DWI and CEUS are not typical,comprehensive judgment needs to be conducted based on previous medical history and laboratory examination data,and a puncture biopsy is needed if necessary.