单、双指数模型扩散加权成像鉴别诊断肝脏富血供病变良恶性的价值

发布时间：2018-04-20 18:43

  本文选题：肝肿瘤 + 肝疾病　； 参考：《中国临床医学影像杂志》2017年01期

【摘要】：目的:探讨单双指数模型扩散加权成像(IVIM-DWI)参数在脏脏富血供良恶性病变鉴别诊断中的应用价值。资料与方法:回顾性分析经穿刺手术病理、临床或随访结果明确诊断的44例患者(48个病灶),其中恶性25例(26个病灶),良性19例(22个病灶)。上述患者行MR常规平扫及增强扫描、并行多b值DWI(b=0、50、100、150、200、400、600、800、1 000、1 200 s/mm~2)获得单指数模型参数ADC值(b=0、800 s/mm~2)及IVIM双指数模型参数:快速扩散系数D_(fast)值、慢速扩散系数D_(slow)值及快速扩散成分所占百分比F值。数据分析包括:肝富血供良恶性病变组的ADC值、D_(fast)值、D_(slow)值、F值比较采用独立样本t检验进行统计学分析:应用受试者工作特征(ROC)曲线评价上述参数值对肝脏良恶性病变鉴别及富血供乏血供病变评定中的价值。结果:富血供良性病变组的ADC值、D_(slow)值、D_(fast)值、F值分别为(1.75±0.68)×10~(-3)mm~2/s、(1.61±0.39)×10~(-3)mm~2/s、(30.93±20.00)×10~(-3)mm~2/s、(34.01±11.48)%高于恶性病变组(1.21±0.21)×10~(-3)mm~2/s、(0.99±0.19)×10~(-3)mm~2/s、(28.56±18.56)×10~(-3)mm~2/s、(31.37±9.86)%,两者之间ADC值、D_(slow)值具有统计学差异,D_(fast)值、F值无统计学差异。ROC曲线评价ADC值、D_(slow)值、D_(fast)值、F值鉴别诊断肝脏富血供良恶性病变阈值、敏感性、特异性、准确性及曲线下面积分别为1.35×10~(-3)mm~2/s、80.76%、86.36%、83.33%、0.875;1.25×10~(-3)mm~2/s、92.30%、95.45%、95.83%、0.945;20.61×10~(-3)mm~2/s、46.12%、72.72%、60.87%、0.534;32.36%、53.84%、68.18%、60.41%、0.545。结论:单指数模型参数ADC值、IVIM双指数模型参数D_(slow)值对肝脏富血供良恶性病变具有鉴别诊断价值,其中D_(slow)值的诊断价值最大。
[Abstract]:Objective: to evaluate the value of single and double exponential diffusion weighted imaging IVIM-DWI parameters in differential diagnosis of benign and malignant lesions with rich blood supply in visceral organs. Materials and methods: Forty-four patients (48 lesions) diagnosed by biopsy, clinical or follow-up findings were retrospectively analyzed, including 25 malignant lesions (26 lesions) and 19 benign lesions (22 lesions). The patients were examined with conventional Mr scan and enhanced Mr scan, and the patients were examined with multiple b values DWII / BX / 50 / 150 / 20040000800 / 1 000 sr / mm / 2). The single index model parameter (ADC) and the double index model parameter of IVIM: rapid diffusion coefficient (DV) were obtained, and the two parameters of the model were: fast diffusion coefficient (DV), Dfast diffusion coefficient (DV). The value of slow diffusion coefficient (D) and the percentage of fast diffusion composition F value. The data analysis includes: the ADC value of the patients with benign and malignant diseases with rich blood supply of liver and the value of D _ S / D _ T are compared. The independent sample t-test is used to carry out statistical analysis: the above parameters are evaluated by using the operating characteristic curve of the subjects to evaluate the effect of the above parameters on the benign and malignant liver. The value of differential diagnosis and evaluation of hyperglycemia and lack of blood supply. 缁撴灉:瀵岃��渚涜壇鎬х梾鍙樼粍鐨凙DC鍊，

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