| 何梦琪,许乙凯,张静,郑泽宇,雷李智,侯美蓉.IVIM-DWI鉴别诊断肝细胞癌和肝局灶性结节增生[J].中国医学影像技术,2017,33(6):907~911 |
| IVIM-DWI鉴别诊断肝细胞癌和肝局灶性结节增生 |
| Evaluation of intravoxel incoherent motion DWI in differential diagnosis of hepatocellular carcinoma and focal nodular hyperplasia |
| 投稿时间：2016-11-21 修订日期：2017-02-15 |
| DOI：10.13929/j.1003-3289.201611106 |
| 中文关键词: 体素内不相干运动 扩散磁共振成像 癌,肝细胞 局灶性结节增生 |
| 英文关键词:Intravoxel incoherent motion Diffusion magnetic resonance imaging Carcinoma, hepatocellular Focal nodular hyperplasia |
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| 中文摘要: |
| 目的 探讨体素内不相干运动扩散加权成像（IVIM-DWI）鉴别肝细胞癌（HCC）与肝局灶性结节增生（FNH）的价值。方法 对407例临床疑似HCC或FNH的患者行常规上腹部MR平扫、动态增强及IVIM-DWI扫描，60例患者（40例HCC，20例FNH）入组。IVIM采用单、双指数模型获得表观扩散系数（ADC）、慢速表观扩散系数（D）、快速表观扩散系数（D*）及快速扩散成分所占比例（f）。结果 FNH组的ADC、D、D*及f值分别为（1.60±0.25）×10-3mm2/s、（1.12±0.17）×10-3mm2/s、（44.89±18.23）×10-3mm2/s和（34.80±9.68）%；HCC组分别为（1.32±0.21）×10-3mm2/s、（0.82±0.21）×10-3mm2/s、（49.82±20.11）×10-3mm2/s和（28.72±13.84）%。2组间的ADC、D值差异有统计学意义（P均<0.001），而D*、f值差异无统计学意义（P>0.05）。D值相应ROC曲线下面积为0.90，以0.96×10-3mm2/s为阈值诊断HCC的敏感度、特异度分别为84.44%、90.02%。结论 IVIM-DWI有助于鉴别诊断HCC和FNH，其中双指数模型计算的D值诊断效能更高。 |
| 英文摘要: |
| Objective To explore the feasibility of intravoxel incoherent motion DWI (IVIM-DWI) in differential diagnosis of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH). Methods A total of 407 patients with clinically-suspected HCC or FNH underwent conventional and dynamic enhanced MRI and IVIM-DWI, 60 patients (40 cases of HCC, 20 cases of FNH) were enrolled. Parameters of ADC, slow apparent diffusion coefficient (D), fast apparent diffusion coefficient (D*) and fraction of fast apparent diffusion coefficient (f) were obtained by monoexponential model and biexponential model respectively. Results The values of ADC, D, D* and f in FNH group were (1.60±0.25)×10-3 mm2/s, (1.12±0.17)×10-3 mm2/s, (44.89±18.23)×10-3 mm2/s and (34.80±9.68)%, and those in HCC group were (1.32±0.21)×10-3 mm2/s, (0.82±0.21)×10-3 mm2/s, (49.82±20.11)×10-3 mm2/s and (28.72±13.84)%, respectively. Significant inter-group differences were observed in ADC and D (both P<0.001), however, there were no significant differences in D* and f (both P>0.05). The areas under the ROC curve of D were 0.90, and taking D=0.96×10-3 mm2/s as cut-off value, the sensitivity and specificity of D in diagnosis of HCC were 84.44% and 90.02%. Conclusion IVIM-DWI is useful to distinguish FNH from HCC, and the D value in biexponential model has the best diagnostic efficacy for differentiations. |
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