扩散加权磁共振成像对肝脏肿块鉴别诊断的贡献。

Contribution of diffusion-weighted MRI to the differential diagnosis of hepatic masses.

作者信息

Demir Ozgün Ilhan, Obuz Funda, Sağol Ozgül, Dicle Oğuz

机构信息

Department of Radiology, Dokuz Eylül University School of Medicine, Izmir, Turkey.

出版信息

Diagn Interv Radiol. 2007 Jun;13(2):81-6.

PMID:17562512

Abstract

PURPOSE

To evaluate the diagnostic contribution of diffusion-weighted magnetic resonance imaging (MRI) using apparent diffusion coefficient (ADC) values to the characterization of hepatic masses and differentiation of benign and malignant lesions.

MATERIALS AND METHODS

The study included 30 patients that underwent upper abdominal MRI examinations because of hepatic masses that were found to be > or =1 cm in size with conventional sequences, and were additionally evaluated with diffusion-weighted MRI. Diffusion-weighted images and ADC maps in the axial plane were obtained using a 1.5 Tesla MRI device, single shot echo-planar spin echo sequences on 3 axes (x, y, z), and diffusion sensitive gradients with 2 different b values (b = 0 and b = 1000 s/mm (2)). Mean ADC measurements were calculated among the 30 cases involving 41 hepatic masses.

RESULTS

Of the 41 hepatic masses, 24 were benign and 17 were malignant. Benign lesions included 6 cysts, 14 hemangiomas, 2 abscesses, and 2 hydatid cysts. Malignant masses included 8 metastases, 4 hepatocellular carcinomas, 4 cholangiocellular carcinomas, and 1 gall bladder adenocarcinoma. The highest ADC values were for cysts and hemangiomas. The mean ADC value of benign lesions was 2.57 +/- 0.26 x 10(-3)mm(2)/s, whereas malignant lesions had a mean ADC value of 0.86 +/- 0.11 x 10(-3)mm(2)/s. The mean ADC value of benign lesions was significantly higher than that of malignant lesions (P < 0.01).

CONCLUSION

Diffusion-weighted MRI with quantitative ADC measurements can be useful in the differentiation of benign and malignant liver lesions.

摘要

目的

评估使用表观扩散系数（ADC）值的扩散加权磁共振成像（MRI）对肝脏肿块特征及良恶性病变鉴别的诊断价值。

材料与方法

本研究纳入30例因肝脏肿块接受上腹部MRI检查的患者，这些肿块在常规序列检查中发现大小≥1 cm，并额外接受了扩散加权MRI检查。使用1.5特斯拉MRI设备，在三个轴（x、y、z）上采用单次激发回波平面自旋回波序列，以及具有2个不同b值（b = 0和b = 1000 s/mm²）的扩散敏感梯度，获取轴向平面的扩散加权图像和ADC图。计算30例患者中41个肝脏肿块的平均ADC测量值。

结果

41个肝脏肿块中，24个为良性，17个为恶性。良性病变包括6个囊肿、14个血管瘤、2个脓肿和2个包虫囊肿。恶性肿块包括8个转移瘤、4个肝细胞癌、4个胆管细胞癌和1个胆囊腺癌。囊肿和血管瘤的ADC值最高。良性病变的平均ADC值为2.57±0.26×10⁻³mm²/s，而恶性病变的平均ADC值为0.86±0.11×10⁻³mm²/s。良性病变的平均ADC值显著高于恶性病变（P < 0.01）。