扩散加权成像在鉴别肝细胞肝癌和周围型胆管细胞癌中的价值

发布时间：2018-01-05 02:16

本文关键词：扩散加权成像在鉴别肝细胞肝癌和周围型胆管细胞癌中的价值　出处：《临床放射学杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨扩散加权成像(DWI)在肝细胞肝癌和周围型胆管细胞癌鉴别诊断中的价值。方法搜集经病理证实的肝细胞肝癌患者30例和周围型胆管细胞癌患者20例,均行b值为800 s/mm~2的DWI检查,比较两组表观扩散系数(ADC)值、瘤/肝值之间的差异,以及肿瘤与邻近肝实质之间的差异;采用受试者工作特征(ROC)曲线确定DWI对肝细胞肝癌和周围型胆管细胞癌的诊断效能及二者鉴别的最佳ADC值和瘤/肝值临界值。结果50例患者共54个肿瘤,所有肿瘤在DWI像上呈高信号,ADC图像呈低信号。肝细胞肝癌和周围型胆管细胞癌平均ADC值分别为(0.89±0.15)×10~(-3)mm~2/s和(1.05±0.14)×10~(-3)mm~2/s,二者差异有统计学意义(t=3.685,P0.01),二者ADC值均低于邻近肝实质。肝细胞肝癌瘤/肝值低于周围型胆管细胞癌瘤/肝值,二者差异有统计学意义(t=2.760,P0.01);ROC曲线确定ADC值和瘤/肝值诊断肝细胞肝癌和周围型胆管细胞癌的临界值分别为0.94×10~(-3)mm~2/s和0.83,敏感性和特异性分别为85%、70%和85%、60%,曲线下面积为0.783和0.732。结论DWI对肝细胞肝癌和周围型胆管细胞癌的鉴别诊断具有一定的价值。
[Abstract]:Objective to investigate diffusion weighted imaging (DWI). Methods 30 cases of hepatocellular carcinoma and 20 cases of peripheral cholangiocarcinoma confirmed by pathology were collected. All patients were examined with DWI with b value of 800s / mm-2. The apparent diffusion coefficient (ADCC), tumor / liver value and the difference between tumor and adjacent hepatic parenchyma were compared between the two groups. Using the operating characteristics of the subjects (ROC). The diagnostic efficacy of DWI for hepatocellular carcinoma and peripheral cholangiocarcinoma and the optimal ADC value and tumor / liver critical value for differentiating them were determined. Results there were 54 tumors in 50 patients. All tumors showed high signal intensity on DWI images. The mean ADC values of hepatocellular carcinoma and peripheral cholangiocarcinoma were 0.89 卤0.15) 脳 10 ~ (-3) mm ~ (-1) / s and 1.05 卤0.14, respectively. 2 / s. The difference between the two groups was statistically significant (P 0.01). The ADC values of the two groups were lower than those of the adjacent hepatic parenchyma, and the value of HCC / HCC was lower than that of peripheral cholangiocarcinoma / liver cancer. The difference between them was statistically significant (P 0.01). The critical values of ADC value and tumor / liver value for the diagnosis of hepatocellular carcinoma and peripheral cholangiocarcinoma were 0.94 脳 10 ~ (-3) mm ~ (-1) / s and 0.83 脳 10 ~ (-3) mm ~ (-1), respectively. The sensitivity and specificity were 85% and 60%, respectively. The areas under the curve are 0.783 and 0.732.Conclusion DWI is valuable in the differential diagnosis of hepatocellular carcinoma and peripheral cholangiocarcinoma.
【作者单位】：安徽医科大学第一附属医院影像科;安徽省太和县人民医院磁共振室;
【分类号】：R735;R445.2
【正文快照】： 磁共振扩散加权成像(diffusion weighted ima-ging,DWI)通过检测生物组织内水分子状态的改变而间接反映组织结构及细胞密度等信息,是目前唯一可以在分子水平对组织内水分子进行研究的功能成像方法。胆管细胞癌(cholangiocellular carcino-ma,CCC)是发生于胆管上皮的腺癌,是发

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