乙肝肝硬化背景下T2WI结合DWI对LI-RADS分类诊断效能的研究

发布时间：2018-03-29 15:21

  本文选题：癌　切入点：肝细胞　出处：《中国医学影像学杂志》2017年11期

【摘要】：目的乙肝肝硬化背景下,探讨肝脏影像报告与数据系统(LI-RADS,2014版)定义的2个辅助征象(T2WI轻-中度高信号与扩散受限)对肝细胞癌(HCC)的诊断价值。资料与方法回顾性分析北京友谊医院2012年1月—2016年11月69例HCC患者共77个分类到LI-RADS 3~5的病灶,大小1.1 cm×0.7 cm~12.7 cm×9.1 cm。图像包括MRI平扫加多期动态增强扫描。由2名影像科医师分析图像,如有分歧结合肝脏容积加速采集加多期动态增强扫描达成共识。比较T2WI和扩散加权成像(DWI)序列的噪声比(CNR)及表观扩散系数(ADC)图的差异,以及两种征象的识别是否一致。结果乙肝肝硬化背景下,T2WI轻-中度高信号与扩散受限对识别分类到LI-RADS 3~5的病灶差异无统计学意义(P0.05),但是b=600 s/mm~2较b=0的DWI识别率更高(70.1%比61.0%,P0.05)。CNR在DWI(b=0、600 s/mm~2)序列上均较T2WI序列上高(P0.01)。病灶最大径≥2 cm较最大径2 cm病灶的ADC值更低[(1.37±0.51)×10~(-3) mm~2/s比(1.57±0.37)×10~(-3) mm~2/s,P0.05]。结论T2WI轻-中度高信号和扩散受限检出病灶的敏感性方面无显著差异。但是由于CNR不同,b=600 s/mm~2的DWI对病灶显示更加明显,在实际工作中可以优先观察。
[Abstract]:Objective under the background of hepatitis B cirrhosis, To explore the diagnostic value of two auxiliary signs defined by liver imaging reporting and data system (LI-RADS2014) for hepatocellular carcinoma (HCC) on T2WI with mild to moderate hyperintensity and diffusion limitation. The data and methods were retrospectively analyzed in Beijing Friendship Hospital 2012 1. From June to November 2016, a total of 77 lesions of 69 HCC patients were classified into LI-RADS 3 or 5 lesions. The size was 1. 1 cm 脳 0. 7 cm~12.7 cm 脳 9. 1 cm. The images included MRI plain scan and multi-phase dynamic enhancement scan. The images were analyzed by 2 imaging physicians, and 1. 1 cm 脳 0. 7 cm~12.7 cm 脳 9. 1 cm. If there is a consensus on the combination of T2WI and DWI, the difference of noise ratio and apparent diffusion coefficient (DWI) of T2WI and diffusion-weighted imaging (DWI) sequences are compared. Results in the background of hepatitis B cirrhosis, there was no significant difference between mild to moderate hyperintense and diffusion-limited T2WI in the identification of lesions classified to LI-RADS 3M 5. However, the DWI recognition rate of BG600 s/mm~2 was higher than that of BX 0. 70.1% was higher than 61.0% in DWI(b=0600 s / mm-2) sequence. The ADC value of lesion with maximum diameter 鈮，

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