摘要
目的探讨分析弥散加权成像(diffusion-weighted imaging,DWI)和表观扩散系数(apparent diffusion coefficient,ADC)在肝脏局灶性病变鉴别诊断中的应用价值。方法对2016年8月至2017年5月庆云县人民医院65例有肝脏内局灶性病变(focal liver lesion,FLL)的患者的DWI扫描(b=50,400,800s/mm^2)进行回顾性分析。测量其中104个病灶(包括56个良性病变和48个恶性病变)实质部分的平均ADC值,避开内部坏死区。分别计算良性病变和恶性病变的特异度和敏感度。运用方差分析检测各类局灶性病变的组间差异。结果恶性病变的平均ADC值为0. 980×10^(-3)mm^2/s,明显低于良性病变的平均ADC值(1. 433×10^(-3)mm^2/s),有统计学意义(P <0. 05)。当ADC值为1. 066×10^(-3)mm^2/s时,恶性肿瘤的特性度和敏感度分别为86. 6%和73. 6%。在所有的病灶中,约39. 5%的病灶平均ADC值低于1. 0×10^(-3)mm^2/s,这些病灶中恶性病变占90%。约20%的病灶平均ADC值大于1. 5×10^(-3)mm^2/s,他们中有9. 5%的为恶性病变。结论 DWI的应用提高了磁共振对于肝脏良恶性病变鉴别的能力,尽管ADC值不能作为肝局灶性病变良恶性鉴别的特异性指标,但其可以作为一项鉴别良恶性性病变的重要参考数据。
Objective To assess the application value of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)in differential diagnosis of focal liver lesion(FLL).Methods The DWI data(b=50400800s/mm^2)of65patients with FLL from August2016to May2017in County People's Hospital were retrospectively analyzed.The mean ADC value was measured in104lesions(56benign and48malignant)excluding internal necrotic areas.The sensitivity and specificity in distinguishing benign from malignant lesions were calculated.Analysis of variance was performed to detect differences among subgroups of solid lesions.Results The mean ADC value of malignant lesions was0.980×10^-3mm^2/s,significantly lower than that of benign lesions(1.433×10^-3mm^2/s,P<0.05).Applying an ADC cutoff of1.066×10^-3mm^2/s,the specificity and sensitivity for malignancy were respectively86.6%and73.6%.Of all lesions,39.5%presented ADC values lower than1.0×10^-3mm^2/s,with90.0%chance of malignancy.Above1.5×10^-3mm^2/s(about20%of all lesions)chance of malignancy was9.5%.Conclusion The application of DWI can improve the ability in differentiating malignant from benign lesions.The ADC value can not be considered as a specific indicator for differential diagnosis of benign and malignant FLL,but it can be used as reference data.
作者
王琛
杨洪霞
Wang Chen;Yang Hongxia(Department of Imaging,Qingyun County People′s Hospital of Shandong Province,Qingyun 253700,China;Emergency Center,Qingyun County People′s Hospital of Shandong Province,Qingyun 253700,China)
出处
《中华消化病与影像杂志（电子版）》
2018年第6期261-266,共6页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
关键词
弥散加权成像
表观扩散系数
磁共振成像
肝脏局灶性病变
Diffusion-weighted imaging
Apparent diffusion coefficient
Magnetic resonance imaging
Focal liver lesion
作者简介
通信作者: 王琛,Email:gaami@163.com
