体素内不相干运动DWI对肝脏良恶性病变的诊断价值

发布时间：2018-03-11 19:38

本文选题：肝肿瘤　切入点：磁共振成像　出处：《放射学实践》2016年04期 　论文类型：期刊论文

【摘要】：目的:探讨体素内不相干运动(IVIM)扩散加权成像对肝脏良恶性病变的诊断价值。方法:搜集2014年12月-2015年7月临床怀疑为肝脏肿瘤、且经手术病理、穿刺活检、临床或随访明确诊断的92例患者(共93个病灶)的病例资料,其中恶性组69例、良性组23例(24个病灶)。所有患者均行常规MRI平扫、多期动态增强扫描及IVIM(b=0、20、50、100、200、400、600、800和1200s/mm2)。将ROI放置于肿瘤最大实性区域,采用单指数及双指数模型获得以下参数值:表观扩散系数(ADC)、慢速表观扩散系数(D)、快速表观扩散系数(D*)及快速扩散成分所占比例(f)。采用独立样本t检验比较良恶性组间各参数的差异,并采用受试者工作特征曲线(ROC)计算各参数的诊断效能。结果:良性病变的ADC、D、D*和f值分别为(1.67±0.59)×10-3、(1.23±0.34)×10-3、(36.13±17.84)×10-3 mm2/s和(29.96%±15.67%),恶性组者分别为(1.20±0.36)×10-3、(0.88±0.21)×10-3、(34.84±19.75)×10-3 mm2/s和(21.77%±10.07%)。除D*值外,ADC值、D值及f值在两组间的差异有统计学意义(P值分别为0.001、0.000及0.023),相应ROC下面积分别为0.764、0.804及0.665。以D值1.13×10-3 mm2/s为阈值,诊断肝脏恶性肿瘤的敏感度及特异度分别为85.5%和62.5%。结论:体素内不相干运动扩散加权成像有助于肝脏良恶性病变的鉴别,其中使用双指数模型计算的慢速表观扩散系数值诊断效能最高。
[Abstract]:Objective: to investigate the diagnostic value of diffusion-weighted imaging (DWI) for benign and malignant liver lesions. Methods: from December 2014 to July 2015, the clinical suspected hepatic tumors were collected, which were surgically and pathologically, and were biopsied. The data of 92 cases (93 lesions) diagnosed by clinical or follow-up were confirmed, including 69 cases of malignant group and 23 cases of benign group (24 lesions). All the patients underwent routine MRI plain scan. Multiphase dynamic enhanced scanning and IVIMI / BX / 20 / 50 / 100 / 100 / 200s / mm2. ROI was placed in the maximum solid area of the tumor, and was placed in the most solid area of the tumor, and was placed in the most solid area of the tumor. The following parameter values were obtained by using single and double exponential models: apparent diffusion coefficient (ADCA), slow apparent diffusion coefficient (D), rapid apparent diffusion coefficient (D _ (1)) and the proportion of fast diffusion components. The independent sample t test was used to compare benign and malignant components. The differences of parameters among groups, The diagnostic efficacy of each parameter was calculated by using the operating characteristic curve of the subjects. Results: the values of D * and f in benign lesions were 1.67 卤0.59) 脳 10-3 (1.23 卤0.34) 脳 10-3 mm2/s and 29.96% 卤15.6767 mm2/s, respectively. The values of D and f in malignant group were 1.20 卤0.36) 脳 10-3 (0.88 卤0.21) 脳 10-3 mm2/s and 21.77% 卤10.0775 mm2/s, respectively. The difference was statistically significant (P = 0. 001) and 0. 023 (P = 0. 023), respectively. The corresponding area under ROC was 0. 764 0. 804 and 0. 665. The threshold value of D value was 1. 13 脳 10 ~ (-3) mm2/s, and that of D was 0. 13 脳 10 ~ (-3) mm2/s. The sensitivity and specificity of diagnosis of hepatic malignant tumors were 85.5% and 62.5.Conclusion: DWI is helpful in differentiating benign and malignant liver lesions. The value of slow apparent diffusion coefficient calculated by double exponential model is the most effective.
【作者单位】：北京协和医学院中国医学科学院肿瘤医院影像诊断科;
【分类号】：R445.2;R735.7

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