3.0T磁共振弥散加权成像在肝脏局灶性病变中的诊断价值初探

目的初步探讨3.0T磁共振弥散加权成像（DWI）对肝脏局灶性病变的鉴别诊断价值。方法采用GE 3.0T Signal EXCITE超导型磁共振扫描系统对65例共68个病灶患者行DWI,并分析病灶信号特征。肝囊肿13个病灶,肝血管瘤12个病灶,炎性假瘤4个病灶,局灶性结节性增生（FNH）5个病灶;肝细胞癌13个病灶,转移瘤21个病灶。应用弥散敏感系数b值0、500、1000 s/mm2的图像拟合出ADC图并测量ADC值。结果肝囊肿、血管瘤、炎性假瘤、FNH、肝细胞癌、转移瘤平均ADC值（×10-3mm2/s）分别为3.34±0.45、2.07±0.35、1.59±0.16、1.50±0.18、1.25±0.31、1.04±0.20;肝囊肿、血管瘤与其它病灶平均ADC之间差异均有统计学意义（P〈0.05）。随着b值的增加,肝囊肿信号衰减最明显,肝细胞癌、转移瘤信号衰减不明显。结论 3.0T磁共振弥散加权成像及其定量ADC值对肝脏占位病变的鉴别诊断具有重要的临床价值。

Contribution of diffusion weighted MR imaging in the differential diagnosis of focal hepatic lesions at 3T

Objective To evaluate the value of diffusion weighted imaging（DWI） in differential diagnosis of focal hepatic lesions.Methods a total of 68 lesions in 65 patients were evaluated,DWI with b=0,500,1000s/mm2 was performed on GE Signal EXCITE at 3.0T.Apparent diffusion coefficient（ADC） values were measured in 13 hepatic cysts,12 hemangiomas,4 inflammatory pseudotumor,5 FNH,13 hepatocellular carcinoma（HCC）,21metastases.And the signature analysis of lesions were performed simultaneously.Results The mean ADC（×10-3mm2/s）value of cysts was 3.34±0.45,hemangiomas 2.07±0.35,inflammatory pseudotumor 1.59±0.16,FNH 1.50±0.18,HCC 1.25±0.31,metastases 1.04±0.20;hepatic cysts and hemagiomas were easily distinguished from other lesions（P〈0.05）;the signal intensity of cysts decreased obviously with the b value being large,on the contrary,the signal intensity of HCC and metastases decreased poorly.Conclusion DWI is useful for differential diagnosis of focal hepatic lesions clinically.