弥散加权成像及磁共振成像增强扫描在肝脏局灶性病变中的诊断价值

Diagnostic Value of Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Focal Liver Lesions

目的:探讨弥散加权成像(DWI)及磁共振成像增强扫描(DCE-MRI)在肝脏局灶性病变(FLLs)中的诊断价值。方法:选取2019年6月-2022年6月南通市通州区中医院收治的经临床医师初步诊断为FLLs的患者52例为研究对象,所有患者采用1.5 T超导磁共振成像仪进行扫描,扫描成像序列基本涵盖T2加权成像、MRI增强扫描、T1加权成像、DWI。比较不同病变检出情况、弥散系数(ADC)值、DCE-MRI参数。结果:DCE-MRI联合DWI的原发性肝癌、肝血管瘤、肝转移癌检出率高于DCE-MRI,差异有统计学意义(P<0.05)。原发性肝癌的ADC值为(1.18±0.22)×10^(-3) mm^(2)/s,肝血管瘤的ADC值为(2.37±0.44)×10^(-3) mm^(2)/s,肝转移癌的ADC值为(1.23±0.27)×10^(-3) mm^(2)/s,肝血管瘤的ADC值>原发性肝癌ADC值>肝转移癌,三种类型病灶的ADC值比较,差异有统计学意义(P<0.001)。三种类型病灶患者的SER值比较,差异无统计学意义(P>0.05);三种类型病灶患者的正性增生积分(PEI)、最大下降斜率(MSD)、最大上升斜率(MSI)、峰值(PV)比较,差异有统计学意义(P<0.05);肝血管瘤患者PEI、MSD、MSI、PV值>原发性肝癌>肝转移癌患者。结论:不同类型FLLs在ADC值和DCE-MRI参数上均存在差异性,其中DCE-MRI联合DWI检查能进一步提高对FLLs病变性质的判断。

Objective:To explore the diagnostic value of diffusion-weighted imaging(DWI)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in focal liver lesions(FLLs).Methods:Fifty-two patients with FLLs who were treated and initially diagnosed by clinicians in Tongzhou District Hospital of Traditional Chinese Medicine of Nantong City from June 2019 to June 2022 were selected as the study subjects.All patients were scanned with 1.5T superconducting magnetic resonance imager.The scanning imaging sequence basically covered T2 weighted imaging,MRI enhanced scan,T1 weighted imaging and DWI.The detections,apparent diffusion coefficient(ADC)value and DCE-MRI parameters of different lesions were compared.Results:The detection rate of primary liver cancer,hepatic hemangioma and liver metastasis of DCE-MRI combined with DWI was higher than that of DCE-MRI,and the difference was statistically significant(P<0.05).The ADC value of primary liver cancer was(1.18±0.22)×10^(-3) mm^(2)/s,the ADC value of hepatic hemangioma was(2.37±0.44)×10^(-3) mm^(2)/s,and the ADC value of liver metastasis was(1.23±0.27)×10^(-3) mm^(2)/s.ADC value was ranked as follows:that of hepatic hemangioma>that of primary liver cancer>that of liver metastasis,and the ADC value of these three types of lesions was compared,and the difference was statistically significant(P<0.001).There was no significant difference in SER value among the patients with these three types of lesions(P>0.05);There were significant differences in the values of positive enhancement integral(PEI),maximum slope of decrease(MSD),maximum slope of increase(MSI),peak to valley(PV)among these three types of lesions(P<0.05).The values of PEI,MSD,MSI and PV were ranked as follows:these values in patients with hepatic hemangioma>these values in patients with primary liver cancer>these values in patients with liver metastasis.Conclusion:There are differences in ADC value and DCE-MRI parameters among different types of FLLs.DCE-MRI combined with DWI examination can further enhanced the determination of the nature of FLLs.