多b值扩散加权成像对肝脏占位病变良恶性的鉴别诊断价值

The Differential Diagnosis Value of Multi-B-value Diffusion Weighted Imaging in Benign and Malignant Hepatic Space-occupying Lesions

目的研究多b值扩散加权成像(DWI)对肝脏占位病变良恶性的鉴别诊断价值。方法选择94例肝脏占位病变患者,94例患者均行MRI平扫及多b值DWI检查。比较肝脏良性与恶性占位患者不同b值下ADC值,计算MRI平扫、不同b值下DWI诊断肝脏良恶性占位敏感度、特异度及准确率。结果94例肝脏占位患者经病理检查证实肝脏良性占位、肝脏恶性占位各有50例、44例;b=600 s/mm^(2)下肝脏良性与恶性占位的ADC值比较,无统计学差异(P>0.05);b=1000、2000 s/mm^(2)下肝脏恶性占位的ADC值低于肝脏良性占位,有统计学差异(P<0.05);b=2000 s/mm^(2)下DWI诊断敏感度高于b=600 s/mm^(2)下DWI、MRI平扫诊断结果,诊断特异度高于MRI平扫,诊断准确率高于b=600、1000 s/mm^(2)下DWI及MRI平扫,有统计学差异(P<0.05)。结论b=2000 s/mm^(2)下DWI检查鉴别诊断肝脏良恶性占位准确率高于b=600、1000 s/mm^(2)下DWI检查及MRI平扫,有利于提高肝脏恶性占位检出率,为临床诊断及治疗提供参考信息。

Objective To study the differential diagnosis value of multi-B-value diffusion weighted imaging(DWI)in benign and malignant hepatic space-occupying lesions.Methods 94 patients with liver occupying lesions were selected.All 94 patients underwent MRI plain scanning and multi-B value DWI examination.The ADC values of benign and malignant liver space-occupying patients with different B values were compared,and the sensitivity,specificity and accuracy of the diagnosis of benign and malignant liver space-occupying patients by MRI plain scanning and DWI under different B values were calculated.Results 94 cases of liver occupying were confirmed by pathological examination,50 cases of benign liver occupying and 44 cases of malignant liver occupying;under b=600 s/mm^(2),there was no statistical difference in ADC value between benign and malignant hepatic space occupancy(P>0.05);under b=1000,2000 s/mm^(2),the ADC value of malignant liver occupying was lower than that of benign liver occupying,and the difference was statistically significant(P<0.05);the diagnostic sensitivity of DWI under b=2000 s/mm^(2)was higher than that of DWI and MRI under b=600 s/mm^(2),the diagnostic specificity was higher than that of MRI under b=2000 s/mm^(2),and the diagnostic accuracy was higher than that of DWI and MRI in B=600 and 1000 s/mm^(2),the difference was statistically significant(P<0.05).Conclusion The accuracy of DWI under b=2000 s/mm^(2)in differential diagnosis of benign and malignant liver space-occupying is higher than that of DWI and MRI under b=600 and 1000 s/mm^(2)under b=2000 s/mm^(2),which is beneficial to improve the detection rate of malignant liver space-occupying and provide reference information for clinical diagnosis and treatment.