Vossen Josephina A, Buijs Manon, Liapi Eleni, Eng John, Bluemke David A, Kamel Ihab R
Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
J Comput Assist Tomogr. 2008 Sep-Oct;32(5):750-6. doi: 10.1097/RCT.0b013e31816a6823.
To evaluate the role of diffusion-weighted imaging in differentiating between hepatic hemangiomas, both typical and atypical, and other hypervascular liver lesions.
Retrospective review of 182 hypervascular liver lesions in 117 patients was performed. Diffusion and contrast-enhanced magnetic resonance imaging were performed using a 1.5-T unit. Imaging protocol consisted of T2-weighted fast spin-echo images, breath-hold diffusion-weighted echo-planar images, and breath-hold unenhanced and contrast-enhanced T1-weighted 3-dimensional fat-suppressed spoiled gradient-echo images in the arterial phase (20 seconds) and portal venous phase (60 seconds). Signal intensity changes and apparent diffusion coefficient (ADC) values were evaluated for all lesions. Unpaired t test was used to compare the mean ADC values for different lesions, and statistical significance was set at P < 0.01. Receiver operating characteristic analysis was used to determine the accuracy of diffusion-weighted imaging in differentiating hemangiomas from other hypervascular liver lesions.
Lesions included typical and atypical hemangioma (n = 38), hepatocellular carcinoma (HCC; n = 58), focal nodular hyperplasia (FNH; n = 22), and neuroendocrine tumor metastasis (NET; n = 64) with a mean tumor size of 5.3 cm. Mean ADC value for hemangioma, HCC, FNH, and NET was 2.29 x 10(-3), 1.55 x 10(-3), 1.65 x 10(-3), and 1.43 x 10(-3) mm2/s, respectively. There was a statistically significant difference in the ADC value of hemangioma compared with that of FNH (P < 0.001), HCC (P < 0.001), and NET (P < 0.001), respectively. The area under the receiver operating characteristic curve was 0.91.
Diffusion-weighted magnetic resonance imaging and ADC maps can provide rapid quantifiable information to differentiate typical and atypical hemangiomas from other hypervascular liver lesions.
评估扩散加权成像在鉴别典型和非典型肝血管瘤与其他富血供肝脏病变中的作用。
对117例患者的182个富血供肝脏病变进行回顾性研究。使用1.5-T设备进行扩散加权及对比增强磁共振成像。成像方案包括T2加权快速自旋回波图像、屏气扩散加权回波平面图像以及屏气未增强和对比增强的T1加权三维脂肪抑制扰相梯度回波图像，分别采集动脉期（20秒）和门静脉期（60秒）图像。评估所有病变的信号强度变化及表观扩散系数（ADC）值。采用非配对t检验比较不同病变的平均ADC值，设定统计学显著性水平为P < 0.01。使用受试者操作特征分析确定扩散加权成像在鉴别血管瘤与其他富血供肝脏病变中的准确性。
病变包括典型和非典型肝血管瘤（n = 38）、肝细胞癌（HCC；n = 58）、局灶性结节性增生（FNH；n = 22）以及神经内分泌肿瘤转移灶（NET；n = 64），平均肿瘤大小为5.3 cm。肝血管瘤、HCC、FNH和NET的平均ADC值分别为2.29×10⁻³、1.55×10⁻³、1.65×10⁻³和1.43×10⁻³ mm²/s。肝血管瘤的ADC值与FNH（P < 0.001）、HCC（P < 0.001）和NET（P < 0.001）相比，差异均具有统计学意义。受试者操作特征曲线下面积为0.91。
扩散加权磁共振成像及ADC图可提供快速定量信息，以鉴别典型和非典型肝血管瘤与其他富血供肝脏病变。
