中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2015年
1期
47-51
,共5页
鲁果果%高雪梅%程敬亮%李玉博%吕晓婷%黄梦月
魯果果%高雪梅%程敬亮%李玉博%呂曉婷%黃夢月
로과과%고설매%정경량%리옥박%려효정%황몽월
肝肿瘤%磁共振成像%对比研究
肝腫瘤%磁共振成像%對比研究
간종류%자공진성상%대비연구
Liver neoplasms%Magnetic resonance imaging%Comparative study
目的 探讨单、双指数模型DWI参数在肝脏良、恶性肿瘤病变鉴别诊断中的价值.方法 回顾性分析临床怀疑为肝占位性病变,且经手术病理、临床或随访结果明确诊断的73例患者.73例患者共88个病灶,分为恶性组46例(53个病灶)和良性组27例(35个病灶).所有患者均行DWI(b=0、800 s/mm2)获得单指数模型参数ADC值,多b值DWI(b=0、20、50、100、200、400、600、800、1 200 s/mm2)获得双指数模型参数慢速表观扩散系数(Slow-A DC)值、快速表观扩散系数(Fast-ADC)值和快速扩散成分所占比例(f)值及平扫与动态增强扫描.记录良、恶性病变的ADC值、Slow-ADC值、Fast-ADC值和f值,并采用独立样本t检验进行比较.以最终诊断结果为金标准,绘制ROC曲线,观察上述参数值的诊断效能.结果 良性组病变的ADC值、Slow-ADC值、Fast-ADC值和f值分别为(1.79±0.35)×10-3mm2/s、(1.67±0.25)×10-3 mm2/s、(72.40±23.70)×103mm2/s和(33.59±11.77)％,恶性组上述参数分别为(1.16±0.36)×10-3mm2/s、(0.94±0.22)×10-3mm2/s、(34.62±17.43)×10-3mm-2/s和(22.28±8.97)％,良性组病变均高于恶性组,差异均有统计学意义(t值分别为0.89、14.77、8.96和5.47,P值均＜0.01).ADC值、Slow-ADC值、Fast-ADC值和f值的ROC曲线下面积分别为0.938、0.974、0.895和0.789,鉴别诊断肝脏良、恶性病变的最佳阈值分别为1.36× 10-3 mm2/s、1.27× 10-3 mm2/s、55.80× 10-3 mm2/s和32.5％.以上参数诊断肝脏恶性病变的敏感度分别为90.6％(48/53)、96.2％(51/53)、90.6％ (48/53)和90.6％ (48/53),特异度分别是85.7％(30/35)、91.4％(32/35)、82.9％ (29/35)和57.1％(20/35).结论 单、双指数模型DWI参数对于鉴别诊断肝脏良、恶性肿瘤病变均有价值,其中Slow-ADC的诊断价值最大.
目的 探討單、雙指數模型DWI參數在肝髒良、噁性腫瘤病變鑒彆診斷中的價值.方法 迴顧性分析臨床懷疑為肝佔位性病變,且經手術病理、臨床或隨訪結果明確診斷的73例患者.73例患者共88箇病竈,分為噁性組46例(53箇病竈)和良性組27例(35箇病竈).所有患者均行DWI(b=0、800 s/mm2)穫得單指數模型參數ADC值,多b值DWI(b=0、20、50、100、200、400、600、800、1 200 s/mm2)穫得雙指數模型參數慢速錶觀擴散繫數(Slow-A DC)值、快速錶觀擴散繫數(Fast-ADC)值和快速擴散成分所佔比例(f)值及平掃與動態增彊掃描.記錄良、噁性病變的ADC值、Slow-ADC值、Fast-ADC值和f值,併採用獨立樣本t檢驗進行比較.以最終診斷結果為金標準,繪製ROC麯線,觀察上述參數值的診斷效能.結果 良性組病變的ADC值、Slow-ADC值、Fast-ADC值和f值分彆為(1.79±0.35)×10-3mm2/s、(1.67±0.25)×10-3 mm2/s、(72.40±23.70)×103mm2/s和(33.59±11.77)％,噁性組上述參數分彆為(1.16±0.36)×10-3mm2/s、(0.94±0.22)×10-3mm2/s、(34.62±17.43)×10-3mm-2/s和(22.28±8.97)％,良性組病變均高于噁性組,差異均有統計學意義(t值分彆為0.89、14.77、8.96和5.47,P值均＜0.01).ADC值、Slow-ADC值、Fast-ADC值和f值的ROC麯線下麵積分彆為0.938、0.974、0.895和0.789,鑒彆診斷肝髒良、噁性病變的最佳閾值分彆為1.36× 10-3 mm2/s、1.27× 10-3 mm2/s、55.80× 10-3 mm2/s和32.5％.以上參數診斷肝髒噁性病變的敏感度分彆為90.6％(48/53)、96.2％(51/53)、90.6％ (48/53)和90.6％ (48/53),特異度分彆是85.7％(30/35)、91.4％(32/35)、82.9％ (29/35)和57.1％(20/35).結論 單、雙指數模型DWI參數對于鑒彆診斷肝髒良、噁性腫瘤病變均有價值,其中Slow-ADC的診斷價值最大.
목적 탐토단、쌍지수모형DWI삼수재간장량、악성종류병변감별진단중적개치.방법 회고성분석림상부의위간점위성병변,차경수술병리、림상혹수방결과명학진단적73례환자.73례환자공88개병조,분위악성조46례(53개병조)화량성조27례(35개병조).소유환자균행DWI(b=0、800 s/mm2)획득단지수모형삼수ADC치,다b치DWI(b=0、20、50、100、200、400、600、800、1 200 s/mm2)획득쌍지수모형삼수만속표관확산계수(Slow-A DC)치、쾌속표관확산계수(Fast-ADC)치화쾌속확산성분소점비례(f)치급평소여동태증강소묘.기록량、악성병변적ADC치、Slow-ADC치、Fast-ADC치화f치,병채용독립양본t검험진행비교.이최종진단결과위금표준,회제ROC곡선,관찰상술삼수치적진단효능.결과 량성조병변적ADC치、Slow-ADC치、Fast-ADC치화f치분별위(1.79±0.35)×10-3mm2/s、(1.67±0.25)×10-3 mm2/s、(72.40±23.70)×103mm2/s화(33.59±11.77)％,악성조상술삼수분별위(1.16±0.36)×10-3mm2/s、(0.94±0.22)×10-3mm2/s、(34.62±17.43)×10-3mm-2/s화(22.28±8.97)％,량성조병변균고우악성조,차이균유통계학의의(t치분별위0.89、14.77、8.96화5.47,P치균＜0.01).ADC치、Slow-ADC치、Fast-ADC치화f치적ROC곡선하면적분별위0.938、0.974、0.895화0.789,감별진단간장량、악성병변적최가역치분별위1.36× 10-3 mm2/s、1.27× 10-3 mm2/s、55.80× 10-3 mm2/s화32.5％.이상삼수진단간장악성병변적민감도분별위90.6％(48/53)、96.2％(51/53)、90.6％ (48/53)화90.6％ (48/53),특이도분별시85.7％(30/35)、91.4％(32/35)、82.9％ (29/35)화57.1％(20/35).결론 단、쌍지수모형DWI삼수대우감별진단간장량、악성종류병변균유개치,기중Slow-ADC적진단개치최대.
Objective To investigate the utility value of monoexponential and biexponential DWI in the differential diagnosis between benign and malignant liver neoplasms.Methods Seventy three patients with pathologically or clinically confirmed liver mass,were analyzed retrospectively and categorized into benign and malignant groups between January 2013 and October 2013.Malignant group included 46 patients with 53 lesions,while 27 patients in benign group had 35 lesions.All patients underwent MR examinations on 3.0T system (GE 750).Conventional MR T1WI,T2WI,DWI(b=0,800 s/mm2) (to obtain ADC with monoexponential modeling),multi-b value DWI(b=0,20 50,100,200,400,600,800 and 1 200 s/mm2) (to obtain Slow-ADC,Fast-ADC,f with biexponential modeling) and dynamic enhancement were performed.The ADC,Slow-ADC,Fast-ADC and f mean values of benign and malignant liver neoplasms were measured and analyzed by using independent samples t test.Diagnostic efficacy of these parameters in malignant group was evaluated by using receiver operating characteristic curve,with histopathologic findings as the gold standard.Results ADC,Slow-ADC,Fast-ADC and f of malignant group were lower than those of benign group [ADC:(1.79±0.35)× 10-3 mm2/s vs (1.16±0.36) × 10-3 mm2/s; Slow-ADC:(1.67±0.25) × 10-3 mm2/s vs(0.94±0.22)×10-3mm2/s; Fast-ADC(72.40±23.70)×10-3mm2/s vs(34.62±17.43)×10-3mm2/s; and f:(33.59± 11.77)％ vs (22.28±8.97)％ in benign and malignant groups,respectively).Significant inter-group difference was observed in ADC,Fast-ADC,Slow-ADC and f (t=0.89,14.77,8.96 and 5.47,respectively and P＜0.05).The areas under the ROC curve (AUC) of ADC,Slow-ADC,Fast-ADC and fwere 0.938,0.974,0.895 and 0.789,respectively.The sensitivity and specificity of ADC,Slow-ADC,Fast-ADC and fwere 90.6％ (48/53),96.2％ (51/53),90.6％ (48/53) and 90.6％ (48/53) and 85.7％ (30/35),91.4％ (32/35),82.9％ (29/35) and 57.1％ (20/35)respectively for differentiating benign from malignant hepatic lesions.Conclusion ADC obtained with mono-exponential modeling and Fast-ADC,Slow-ADC,f obtained with biexponential modeling are useful parameters in distinguishing benign and malignant hepatic lesions,among which slow-ADC demonstrates the highest diagnostic efficacy.
