CAJ | 학술논문

目的：通过利用核磁DWI联合GRE/T2W多回波技术对肝脏良恶性占位性病变治疗前预测判断，评估核磁DWI联合GRE/T2W多回波技术在肝脏良恶性肿瘤诊断中临床应用价值。方法选取2012年1月至2014年12月期间在新疆兵团一师医院初步诊断为肝脏占位的患者122例，其中男68例，女54例。所有病例在不需用动态增强前提下，同时均进行核磁DWI联合GRE/T2W多回波成像。由有两名高级职称核磁科医师共同参与阅片得出成像结果，并把122例实验室检查结果与MRI结果作对照，采用Kappa检验。将良恶性肿瘤总体ADC值及各种肿瘤或组织间ADC值采用t检验，数据结果应用SPSS统计软件处理，以P<0.05为差异有统计学意义。并参照71例经手术或穿刺的病理结果，计算出DWI联合GRE/T2W多回波成像判断肝脏良恶性占位病变的灵敏度、特异度及复合率。结果肝脏良恶性肿瘤总体ADC值差异有统计学意义（P<0.01），肝脏局灶性增生（FNH）、肝脓肿与肝脏恶性肿瘤ADC值之间差异无统计学意义，DWI联合T2WI多回波技术对肝脏良恶性肿瘤的判断灵敏度是94.5%，特异度是97.6%，复合率为96.8%。结论在不需要增强扫描的情况下，核磁DWI联合GRE/T2W多回波技术参照常规SE及TSE序列T1W、T2W成像，可较准确地对肝脏良恶性肿瘤做术前诊断，有很好的临床应用价值。
목적：통과이용핵자DWI연합GRE/T2W다회파기술대간장량악성점위성병변치료전예측판단，평고핵자DWI연합GRE/T2W다회파기술재간장량악성종류진단중림상응용개치。방법선취2012년1월지2014년12월기간재신강병단일사의원초보진단위간장점위적환자122례，기중남68례，녀54례。소유병례재불수용동태증강전제하，동시균진행핵자DWI연합GRE/T2W다회파성상。유유량명고급직칭핵자과의사공동삼여열편득출성상결과，병파122례실험실검사결과여MRI결과작대조，채용Kappa검험。장량악성종류총체ADC치급각충종류혹조직간ADC치채용t검험，수거결과응용SPSS통계연건처리，이P<0.05위차이유통계학의의。병삼조71례경수술혹천자적병리결과，계산출DWI연합GRE/T2W다회파성상판단간장량악성점위병변적령민도、특이도급복합솔。결과간장량악성종류총체ADC치차이유통계학의의（P<0.01），간장국조성증생（FNH）、간농종여간장악성종류ADC치지간차이무통계학의의，DWI연합T2WI다회파기술대간장량악성종류적판단령민도시94.5%，특이도시97.6%，복합솔위96.8%。결론재불수요증강소묘적정황하，핵자DWI연합GRE/T2W다회파기술삼조상규SE급TSE서렬T1W、T2W성상，가교준학지대간장량악성종류주술전진단，유흔호적림상응용개치。
Objective It predicts and judges Lesions caused by benign and malignant hepatic tumor before being treated by Magnetic DWI combined with muti-Echo technique of GRE/T2W, and that clinical value is to be evaluated in the benign and malignant hepatic tumor.Methods 122 cases were selected that had been diagnosed as hepatic lesions from January 2012 to December 2014, among of them 68 cases were male and 54 cases were female. All the cases were imaged at the same time by Magnetic DWI combined with muti-Echo technique of GRE/T2W without dynamic contrast enhance. The imaging results were get after reading the image picture by senior experts from department magnetic co-participation, and then the laboratory pathological findings of 122 cases were compared to MRI results, with kappa test were adopted.ADC value of benign and malignant hepatic tumor, ADC in Various tumor or tissues were performed with T test, and all the data were analysed with SPSS with P less than 0.05 in significance. Subsequently, according to the 71 cases pathology results of operation or puncture, the sensitivity of benign and malignant hepatic tumors, their specificities and recombination rates were calculated based on the images of Magnetic DWI combined with muti-Echo techniques.Results It showed the significance (P<0.01) in the total ADC in benign and malignant hepatic tumors, at the same time, hepatic focal nodular hyperplasia (FNH) was confirmed. however, it did not show the difference in significance between liver abscess and hepatic malignancy. Our analysis findings addressed that the sensitivity of DWI combined with muti-Echo technique of GRE/T2W was 94.5%,as well as their specificites 97.6% and Recombination rates 96.8%.Conclusion Without the enhancement scan, it can preoperative diagnose the benign and malignant hepatic tumors precisely by techniques of Magnetic DWI combined with muti-Echo of GRE/T2W,which following the regular SE and TSE sequence used in T1W、T2W image. Such techniques will provide the prospect application in clinical.