Kim T, Murakami T, Takahashi S, Hori M, Tsuda K, Nakamura H
Department of Radiology, Osaka University Medical School, Suita City, Japan.
AJR Am J Roentgenol. 1999 Aug;173(2):393-8. doi: 10.2214/ajr.173.2.10430143.
The aims of this study were to determine apparent diffusion coefficients (ADCs) of the abdominal organs and liver lesions, to determine the effect of the magnitude of b values on the ADCs, and to determine whether measured ADCs of liver tumors help differentiate benign from malignant lesions.
Six healthy volunteers and 126 patients were examined with diffusion-weighted single-shot echo-planar imaging using multiple b values (maximum, 846 sec/mm2). The ADCs of the liver, spleen, kidney, 49 malignant liver lesions (33 hepatocellular carcinomas, 15 metastatic liver tumors, and one cholangiocellular carcinoma), and 30 benign lesions (17 cysts, 12 hemangiomas, and one angiomyolipoma) were calculated.
The ADCs of the abdominal organs and liver lesions showed smaller values when calculated with the greater maximum b values. The ADCs of the benign lesions calculated with all the b values of less than 850 sec/mm2 (2.49+/-1.39 x 10(-3) mm2/sec) were significantly (p = .0024) greater than those of the malignant lesions (1.01+/-0.38 x 10(-3) mm2/sec). When the maximum b value is 846 sec/mm2, use of a threshold ADC of 1.6 x 10(-3) mm2/sec would result in a sensitivity of 98% and a specificity of 80% for differentiation of malignant liver lesions from benign lesions.
Measurement of ADC has good potential for characterizing liver lesions, but the calculated ADCs could be affected by the magnitude of the maximum b value.
本研究旨在测定腹部器官及肝脏病变的表观扩散系数(ADC),确定b值大小对ADC的影响,并确定所测肝脏肿瘤的ADC是否有助于鉴别良性与恶性病变。
对6名健康志愿者和126例患者采用多b值(最大846秒/平方毫米)的扩散加权单次激发回波平面成像进行检查。计算肝脏、脾脏、肾脏、49个恶性肝脏病变(33个肝细胞癌、15个肝转移瘤和1个胆管细胞癌)以及30个良性病变(17个囊肿、12个血管瘤和1个血管平滑肌脂肪瘤)的ADC。
用最大b值越大时计算出的腹部器官及肝脏病变的ADC值越小。用所有小于850秒/平方毫米的b值计算出的良性病变的ADC(2.49±1.39×10⁻³平方毫米/秒)显著高于恶性病变(1.01±0.38×10⁻³平方毫米/秒)(p = 0.0024)。当最大b值为846秒/平方毫米时,使用1.6×10⁻³平方毫米/秒的ADC阈值可使鉴别恶性与良性肝脏病变的敏感度达98%,特异度达80%。
ADC测量在肝脏病变特征性诊断方面具有良好潜力,但计算出的ADC可能受最大b值大小的影响。