中华消化病与影像杂志（电子版）
中華消化病與影像雜誌（電子版）
중화소화병여영상잡지（전자판）
2012年
1期
39-41
,共3页
阳红艳%顾明%柯振武%何次%关静%田超%龚光辉
暘紅豔%顧明%柯振武%何次%關靜%田超%龔光輝
양홍염%고명%가진무%하차%관정%전초%공광휘
磁共振成像%扩散%肝癌
磁共振成像%擴散%肝癌
자공진성상%확산%간암
Magnetic resonance imaging%Diffusion-weighted imaging%Liver cancer
目的 评估磁共振扩散加权成像(DWI)技术结合动态增强扫描诊断分析原发性肝癌的不同成分的能力.方法 选取成都军区总医院48例原发性肝癌患者行磁共振扩散加权成像( DWI )T1WI、T2WI和T1WI钆对比剂增强扫描,分析观察原发性肝癌存活的肿瘤组织与肿瘤液化坏死组织成分的DWI与增强图像上的信号特征,测量并计算病灶的表观扩散系数值(ADC值)与对应的磁共振T1WI增强扫描最大强化值,进行统计学分析.结果 磁共振DWI成像上肝癌肿瘤组织表现为稍高于周围肝实质的高信号,钆增强扫描显示明显强化；液化坏死部分表现为明亮高信号,增强后无明显强化；ADC图上肿瘤组织为稍高于正常肝实质的高信号,肿瘤坏死组织部分为低信号；扩散敏感因子b= 800 s/mm2时ADC为:肝癌肿瘤组织为(1.02±0.27)×10-3 mm2/s,肿瘤坏死组织为(1.70±0.35)×10-3 mm2/s,正常肝实质为(1.28±0.36)×10-3 mm2/s.肝癌肿瘤组织与肿瘤坏死组织组间差异有统计学意义(t=-10.135,P=0.000),肝癌肿瘤组织与正常肝实质组间信号有差异(t=-3.599,P=0.001),正常肝实质与肿瘤坏死组织组间信号差异显著(t=-5.404,P=0.000).磁共振T1WI增强扫描上肝癌肿瘤组织表现为明显强化,其内液化坏死组织未见明显强化,肝癌组织的ADC值与T1WI增强扫描最大强化值之间呈负性相关关系(r=-0.881,P＜0.01).结论 磁共振扩散成像技术结合ADC值对原发性肝癌的临床诊断及其内部成分分析具有重要的意义.
目的 評估磁共振擴散加權成像(DWI)技術結閤動態增彊掃描診斷分析原髮性肝癌的不同成分的能力.方法 選取成都軍區總醫院48例原髮性肝癌患者行磁共振擴散加權成像( DWI )T1WI、T2WI和T1WI釓對比劑增彊掃描,分析觀察原髮性肝癌存活的腫瘤組織與腫瘤液化壞死組織成分的DWI與增彊圖像上的信號特徵,測量併計算病竈的錶觀擴散繫數值(ADC值)與對應的磁共振T1WI增彊掃描最大彊化值,進行統計學分析.結果 磁共振DWI成像上肝癌腫瘤組織錶現為稍高于週圍肝實質的高信號,釓增彊掃描顯示明顯彊化；液化壞死部分錶現為明亮高信號,增彊後無明顯彊化；ADC圖上腫瘤組織為稍高于正常肝實質的高信號,腫瘤壞死組織部分為低信號；擴散敏感因子b= 800 s/mm2時ADC為:肝癌腫瘤組織為(1.02±0.27)×10-3 mm2/s,腫瘤壞死組織為(1.70±0.35)×10-3 mm2/s,正常肝實質為(1.28±0.36)×10-3 mm2/s.肝癌腫瘤組織與腫瘤壞死組織組間差異有統計學意義(t=-10.135,P=0.000),肝癌腫瘤組織與正常肝實質組間信號有差異(t=-3.599,P=0.001),正常肝實質與腫瘤壞死組織組間信號差異顯著(t=-5.404,P=0.000).磁共振T1WI增彊掃描上肝癌腫瘤組織錶現為明顯彊化,其內液化壞死組織未見明顯彊化,肝癌組織的ADC值與T1WI增彊掃描最大彊化值之間呈負性相關關繫(r=-0.881,P＜0.01).結論 磁共振擴散成像技術結閤ADC值對原髮性肝癌的臨床診斷及其內部成分分析具有重要的意義.
목적 평고자공진확산가권성상(DWI)기술결합동태증강소묘진단분석원발성간암적불동성분적능력.방법 선취성도군구총의원48례원발성간암환자행자공진확산가권성상( DWI )T1WI、T2WI화T1WI구대비제증강소묘,분석관찰원발성간암존활적종류조직여종류액화배사조직성분적DWI여증강도상상적신호특정,측량병계산병조적표관확산계수치(ADC치)여대응적자공진T1WI증강소묘최대강화치,진행통계학분석.결과 자공진DWI성상상간암종류조직표현위초고우주위간실질적고신호,구증강소묘현시명현강화；액화배사부분표현위명량고신호,증강후무명현강화；ADC도상종류조직위초고우정상간실질적고신호,종류배사조직부분위저신호；확산민감인자b= 800 s/mm2시ADC위:간암종류조직위(1.02±0.27)×10-3 mm2/s,종류배사조직위(1.70±0.35)×10-3 mm2/s,정상간실질위(1.28±0.36)×10-3 mm2/s.간암종류조직여종류배사조직조간차이유통계학의의(t=-10.135,P=0.000),간암종류조직여정상간실질조간신호유차이(t=-3.599,P=0.001),정상간실질여종류배사조직조간신호차이현저(t=-5.404,P=0.000).자공진T1WI증강소묘상간암종류조직표현위명현강화,기내액화배사조직미견명현강화,간암조직적ADC치여T1WI증강소묘최대강화치지간정부성상관관계(r=-0.881,P＜0.01).결론 자공진확산성상기술결합ADC치대원발성간암적림상진단급기내부성분분석구유중요적의의.
Objective To investigate prospectively the capability of diffusion-weighted imaging (DWI) for characterize and diagnosis in liver cancer by the apparent diffusion coefficient (ADC).Methods Diffusion-weighted imaging and Dynamid Contrast enhancement MRI were performed in 48 consecutive patients with liver cancer.To analyze MRI findings of lesions.Signal intensities on the DW images and apparent diffusion coefficient (ADC) maps were noted.ADCs and maximum MR T1 -weighted image (T1WI) enhancement value in all lesions were measured and calculated with Student's t test and Pearson correlations.Results The liver cancer lesion showed hyperintensity on diffusion-weighted images and hypointensity on ADC maps.The mean ADCs were ( 1.02±0.27 ) ×10-3mm2/s lesions, ( 1.70±0.35 ) × 10-3 mm2/s in necrosis,( 1.28 ±0.36 ) × 10-3mm2/s in the normal liver parenchyma by b=800s/mm2.At different b values,ADC values of liver,liver tumor tissues and liver necrotic lesions had statistically significant difference (P＜0.01).On post contrast images there is homogeneous enhancement,except for a focal area of hypointensity,possibly an area of necrosis.The ADCs is obviously negative to the maximum MR T1-weighted imaging (T1WI)enhancement value of liver cancer(r=-0.881,P＜0.01).Conclusion DW MR imaging,with the help of quantitative study in liver cancer using ADC value,Would improve the accuracy in detecting different component of liver cancer.It's an useful method for the follow-up.
