Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060 China.
Acad Radiol. 2010 Feb;17(2):239-43. doi: 10.1016/j.acra.2009.09.012. Epub 2009 Dec 4.
To compare diffusion-weighted (DW) with standard T2-weighted imaging for quantitative evaluation of small hepatocellular carcinoma (HCC) in cirrhosis.
Fourteen patients (all men; mean age, 58.6 years; age range, 45-69 years) with 22 small HCCs (<3 cm and >1 cm in diameter) in cirrhosis were included in the study. DW imaging with breath-hold single-shot echo planar imaging (b = 0, 800 seconds/mm(2)) and T2-weighted imaging with respiratory triggering fat-suppressed fast spin-echo sequence were performed on a 3-T magnetic resonance unit using an eight-channel torso phased-array coil. The signal intensity (SI) of HCC and liver were measured at workstation. Contrast-to-noise ratio (CNR), contrast ratio (CR, SI(lesion)/SI(liver)), and apparent diffusion coefficient (ADC) values were calculated. CNRs and CRs obtained with DW and T2-weighted images, and ADCs of HCC and liver were compared using nonparametric tests.
Two lesions were excluded because of artifacts on DW images. Thus 20 lesions were analyzed. The CNRs obtained with T2-weighted images (27.12 + or - 21.12) were significantly higher (P = .02) than those with DW images (17.52 + or - 13.50). There were no significant difference between the CRs obtained with T2-weighted images (1.83 + or - 0.56) and DW images (2.01 + or - 0.67). There were no significant difference between the mean ADCs of HCC (1.22 x 10(-3) mm(2)/second + or - 0.24) and the cirrhotic liver (1.17 x 10(-3) mm(2)/second + or - 0.17), either.
DW imaging with high b value was not superior to standard T2-weighted imaging in terms of lesion conspicuity of small HCC in cirrhosis.
比较扩散加权成像（DW）与标准 T2 加权成像，对肝硬化小肝癌（HCC）进行定量评估。
本研究纳入 14 例男性患者（平均年龄 58.6 岁，年龄范围 45-69 岁），共 22 个肝硬化小 HCC（直径<3cm，>1cm）。采用 3.0T 磁共振仪，8 通道体部相控阵线圈，行单次激发呼吸门控平面回波弥散加权成像（b 值=0、800 秒/mm²）和呼吸触发脂肪抑制快速自旋回波 T2 加权成像。在工作站上测量 HCC 和肝脏的信号强度（SI）。计算 HCC 的对比噪声比（CNR）、对比率（CR，SI（病灶）/SI（肝脏））和表观弥散系数（ADC）值。采用非参数检验比较 DW 和 T2 加权图像的 CNR、CR 和 HCC 及肝脏的 ADC 值。
由于 DW 图像上存在伪影，有 2 个病灶被排除在外，因此共分析了 20 个病灶。T2 加权图像的 CNR（27.12 ± 21.12）显著高于 DW 图像（17.52 ± 13.50，P=0.02）。T2 加权图像和 DW 图像的 CR（1.83 ± 0.56 和 2.01 ± 0.67）之间无显著差异。HCC 的平均 ADC 值（1.22×10⁻³mm²/s±0.24）与肝硬化肝脏的 ADC 值（1.17×10⁻³mm²/s±0.17）之间也无显著差异。
在肝硬化小 HCC 的病灶显示方面，高 b 值的 DW 成像并不优于标准 T2 加权成像。
