肝癌导致门静脉癌栓的ADC和DWI表现及其诊断价值

发布时间：2018-12-26 18:09

【摘要】：目的探讨肝癌导致门静脉癌栓(PVTT)的表观扩散系数(ADC)和扩散加权成像(DWI)表现及其诊断价值。资料与方法选取经临床和MRI诊断为肝癌导致门静脉癌栓的31例患者,共43个肝癌癌灶、63个门静脉主干支癌栓。31例均行常规MRI、DWI和ADC成像,观察肝癌癌灶和PVTT的MRI、ADC和DWI表现,分析癌灶和PVTT ADC值的相关性。结果 43个肝癌癌灶中,DWI表现为低信号、等信号和高信号分别有1个、4个和38个;其ADC表现为低信号、等信号和高信号分别有36个、5个和2个。63支PVTT中,DWI表现为低信号、等信号和高信号分别有4支、7支和52支,其ADC表现为低信号、等信号和高信号分别有54支、6支和3支。2名观察者观察癌灶ADC表现的一致性较好(Kappa=0.8334,P0.05),观察PVTT的一致性中等(Kappa=0.5215,P0.05)。同个体癌灶和PVTT的ADC均值分别为(1.127±0.268)×10-3 mm2/s和(1.021±0.363)×10-3 mm2/s,癌灶和PVTT的ADC值呈正相关(r=0.246,P0.05)。结论 PVTT的ADC低信号、低ADC值和DWI高信号表现,对其定性诊断具有一定的临床应用价值。
[Abstract]:Objective to investigate the apparent diffusion coefficient (ADC) and diffusion-weighted imaging (DWI) findings of portal vein tumor thrombus (PVTT) induced by hepatocellular carcinoma (HCC) and their diagnostic value. Materials and methods 31 patients with portal vein tumor thrombus caused by liver cancer diagnosed by clinical and MRI were selected, including 43 liver cancer foci and 63 portal vein tumor thrombus. 31 patients underwent routine MRI,DWI and ADC imaging to observe the liver cancer focus and MRI, of PVTT. ADC and DWI findings were analyzed to analyze the correlation between tumor focus and PVTT ADC value. Results among 43 liver cancer foci, DWI showed low signal intensity, with 1 with equal signal and 38 with high signal. The ADC showed low signal, the iso-signal and high signal were 36, 5 and 2.63 PVTT respectively, DWI showed low signal, iso-signal and high-signal showed 4, 7 and 52 respectively, and ADC showed low signal. Isointensity and hyperintensity were 54, 6 and 3, respectively. The consistency (Kappa=0.8334,P0.05) of ADC was better in 2 observers and moderate (Kappa=0.5215,P0.05) in PVTT. The mean value of ADC was (1.127 卤0.268) 脳 10 ~ (-3) mm2/s and (1.021 卤0.363) 脳 10 ~ (-3) mm2/s, respectively, and the ADC value of PVTT was positively correlated with the value of PVTT (r = 0.246, P 0.05). Conclusion the ADC low signal, low ADC value and high DWI signal of PVTT have certain clinical application value in qualitative diagnosis.
【作者单位】：江苏省连云港市东方医院(徐州医学院附属连云港东方医院)影像科;
【基金】：2012年江苏省连云港市卫生局指令性科研项目(1236)
【分类号】：R445.2;R735.7

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