摘要
目的：探讨体素内不相干运动磁共振扩散加权成像技术（IVIM DWI）对肝脏占位性病变的诊断价值。方法：对经手术病理证实或临床资料确诊的57例患者（65个肝脏病灶）术前进行3.0T MR DWI扫描,设定12个b值（范围0~1700s/mm2）,扫描图像传至工作站,运用MADC后处理软件进行图像后处理,测量表观扩散系数（ADC）、真实扩散系数（D）、灌注相关扩散系数（D＊）及灌注分数（f）。比较肝脏良、恶性占位性病变各参数之间的差异,采用独立样本t检验及单因素方差分析方法进行统计学分析。结果：肝脏良性占位性病变的ADC及D值[（2.01±0.66）×10-3和（1.61±0.53）×10-3 mm2/s]均高于恶性占位性病变[（1.13±0.35）×10-3和（0.86±0.25）×10-3 mm2/s],差异具有统计学意义,P〈0.001。实性肝脏良性占位性病变的f值（0.49±0.12）明显高于恶性占位性病变（0.29±0.09）,差异具有统计学意义（P〈0.001）。ROC曲线下面积分别为AUCADC=0.877,AUCD=0.913及AUCf=0.892,其诊断肝脏良、恶性占位性病变的敏感度分别为90.9%、97.7%及81.8%,特异度分别为71.4%、71.4%及81.8%。结论：IVIM DWI中ADC值、D值及f值对鉴别肝脏占位性病变有较高的诊断价值,其中D值的诊断价值最大。
Objective：To investigate the value of intra-voxel incoherent motion diffusion-weighted imaging（IVIM DWI）for the diagnosis of hepatic lesions.Methods：A total of 65 hepatic lesions in 57 patients underwent DWI with 12bvalues（0~1700s/mm2）at a 3T MR scanner.All lesions were pathologically or clinically confirmed.All DW-MRI images were transferred to the dedicated workstation and post-processed using MADC software.Apparent diffusion coefficient（ADC）,true diffusion coefficient（D）,perfusion-related diffusion coefficient（D＊）and perfusion fraction（f）were measured respectively.The mean values of these parameters between benign and malignant hepatic lesions were compared to each other with independent samples t-test and one-way ANOVA analysis.Results：ADC and D values were higher in benign[（2.01±0.66）×10-3,（1.61±0.53）×10-3 mm2/s]than in malignant hepatic lesions [（1.13±0.35）×10-3,（0.86±0.25）×10-3 mm2/s];the difference was significant with P-values less than 0.001 for both values.Solid benign hepatic lesions had higher f than malignant lesions（0.49±0.12 vs 0.29±0.09）,with significant difference（P〈0.001）.The areas under the receiver-operating-characteristic（ROC）curve were AUCADC=0.877,AUCD=0.913,AUCf=0.892,respectively.The corresponding sensitivity and specificity were 90.9%,97.7%,81.8% and 71.4%,71.4%,81.8%for ADC,D and f values.Conclusion：On IVIM DWI,ADC,D and f values have high diagnostic value in differentiating hepatic lesions,while D value has the best diagnostic value.
出处
《放射学实践》
北大核心
2016年第6期526-530,共5页
Radiologic Practice
基金
国家自然科学基金(81371524)
国家自然科学青年基金(81501447)
关键词
扩散磁共振成像
肝脏病学
诊断
Diffusion magnetic resonance imaging
Hepatology
Diagnosis
作者简介
李晓娟（1988-），女，新疆昌吉人，硕士研究生，主要从事腹部影像学研究。
通讯作者：，胡道予E-mail：cir．hudaoyu@vip．163．com
