CAJ | 학술논문

目的：探讨磁共振扩散加权成像对肝脏占位性病变的诊断价值。方法对89例肝脏占位性病变（肝细胞癌30例，肝转移瘤26例，肝血管瘤19例，肝囊肿14例）进行DWI成像（扩散敏感系数b值分别取0、100、500和800 s／mm2），测量肝脏各种病变的ADC值，并作对应的统计学比较，分析是否有显著性差异。结果良性肿瘤与恶性肿瘤的平均ADC值存在显著性差异（P＜0．05），转移瘤与肝癌的平均ADC值之间无显著性差异（P＞0．05）。肝癌及肝转移瘤ADC值与本身肝实质ADC值比值之间存在显著性差异（ P＜0．05）。 b值＝500 s／mm2的DWI成像对恶性病灶的检出率高于T2 WI，两者间有统计学差异。结论磁共振扩散加权成像对肝脏占位性病变的诊断与鉴别诊断具有较高的临床应用价值，有利于肝脏恶性小病灶的检出，可作为肝脏常规MRI检查的补充手段。
목적：탐토자공진확산가권성상대간장점위성병변적진단개치。방법대89례간장점위성병변（간세포암30례，간전이류26례，간혈관류19례，간낭종14례）진행DWI성상（확산민감계수b치분별취0、100、500화800 s／mm2），측량간장각충병변적ADC치，병작대응적통계학비교，분석시부유현저성차이。결과량성종류여악성종류적평균ADC치존재현저성차이（P＜0．05），전이류여간암적평균ADC치지간무현저성차이（P＞0．05）。간암급간전이류ADC치여본신간실질ADC치비치지간존재현저성차이（ P＜0．05）。 b치＝500 s／mm2적DWI성상대악성병조적검출솔고우T2 WI，량자간유통계학차이。결론자공진확산가권성상대간장점위성병변적진단여감별진단구유교고적림상응용개치，유리우간장악성소병조적검출，가작위간장상규MRI검사적보충수단。
Objective To evaluate the diagnositc value of diffusion weighted MR imaging ( DWI) in focal hepatic le-sions.Methods 89 patients with focal liver lesions ( hepatic carcinoma 30 cases,hepatic metastasis 26 cases,hepatic hemangio-ma 19 cases,hepatic cyst 14 cases) were examined by diffusion weighted imaging (DWI) (b values were 0 s/mm2、100 s/mm2、500 s/mm2、800 s/mm2 ) .ADCs were measured in all hepatic lesions and correlation analysis was used to determine the relation among the lesions.Results The mean ADCs of benign tumors and malignant tumors were statistically different (P<0.05).The mean ADCs of hepatocellular carcinomas and metastatic liver tumors were not statistically different (P>0.05).The ratio of ADCs of hepatocellular carcinomas and metastatic liver tumors to that of liver parenchyma was statistically different (P<0.05).DWI (b=500 s/mm2) showed higher detection rate for malignant lesions than T2WI,there were statistically significant difference. Conclusion DW MR imaging has important clinical value in the diagnosis and differential diagnosis of focal hepatic lesions,it can improve the detection rate of liver malignant lesions and can be used as a supplementary means of routine MRI examination.