摘要
目的：探讨磁共振扩散峰度成像（DKI）在肝脏占位性病变中的应用价值。方法：回顾性分析经手术病理和/或临床综合诊断肝脏占位性病变69例,多发病变者取其最大病灶,其中肝癌24例,肝转移瘤33例,不典型肝血管瘤12例。所有病例均行常规磁共振成像（MRI）平扫和DKI检查,基于高b值非高斯分布模型拟合得到表观扩散系数（ADC）图、真实扩散系数（D）值图和表观扩散峰度（K）值图。画取最大病灶感兴趣区（ROI）,获得其平均ADC、D、K值;并采用单因素方差分析比较组间和组内差异。结果：肝癌与肝血管瘤比较,其ADC值、D值及K值差异有显著性（P分别为0.003、0.012和〈0.001）;肝转移瘤与非典型肝血管瘤比较,其ADC值、D值及K值差异有显著性（ADC值分别为0.003,0.017和〈0.001）;ADC值、D值、K值在肝癌与肝转移瘤中的差异无显著性（P值分别为0.999,0.976,0.949）。肝癌/肝血管瘤,肝转移瘤/肝血管瘤D值与K值曲线下面积均大于0.8,高于ADC值曲线下面积。在肝癌与肝血管瘤鉴别中其K值敏感性最高,为91.7%,ADC值特异性最高,为91.7%;在肝转移瘤与肝血管瘤鉴别诊断中其K值敏感性最高,为81.8%;ADC值特异性最高,为84.8%。结论：肝脏DKI能提供肝内占位性病变额外诊断信息,可以替代影像学增强检查;提高对肝癌与肝血管瘤、肝转移瘤与肝血管瘤鉴别诊断效能。
Objective：To investigate the value of diffusion kurtosis imaging（DKI）in hepatic space-occupying lesions.Methods：Sixty-nine patients with pathological and/or clinical diagnosis of liver space-occupying lesions were retrospectively analyzed.Among them,24 were hepatic carcinoma（HCC）,33 liver metastases and 12 atypical hepatic hemangiomas.All cases underwent routine MRI scan and DKI,and the apparent diffusion coefficient（ADC）,true diffusion coefficient（D）and apparent diffusion kurtosis（K）were obtained based on the non-Gaussian distribution model.The maximum lesion ROI was drawn and the average ADC,D,K values were obtained.One-way analysis of variance（ANOVA）was used to compare the inter-and intra-group differences.Results：There were significant differences in ADC value,D value and K value between hepatocellular carcinoma and hepatic hemangiomas（P=0.003,0.012 and 0.001,respectively）.ADC value,D value and K value were also significantly different between hepatic metastases and hepatic hemangiomas（ADC values were 0.003,0.017 and0.001,respectively）.There were significant differences in ADC value,D value and K value between hepatocellular carcinoma and liver metastases（P=0.999,0.976,0.949,respectively）.The areas under the curve of liver cancer/hepatic hemangioma,liver metastatic tumor/hepatic hemangioma were all larger than 0.8,higher than the area under the curve of ADC value.In the identification of liver cancer and hepatic hemangioma,the K value was the most sensitive,which was 91.7%,and ADC value was the most specific,which was 91.7%.The K value was the most sensitive in differential diagnosis between liver metastasis and hepatic atypical hemangioma（81.8%）;and the specificity of ADC value was the highest（84.8%）.Conclusion：Liver DKI can provide additional diagnostic information on intrahepatic space-occupying lesions and can be used as an alternative method for contrast test;Furthmore,the DKI can improve the differential diagnostic performance for liver cancer and live
作者
范晨虹
凌公豪
谢辉
吴光耀
FAN Chenhong;LING Gonghao;XIE Hui;WU Guangyao(Dept. of Medical Imaging, Zhongnan Hospital of Wuhan University, Wuhan 430071 , China;Dept. of Biomedical Engineering, School of Basic Medical Sciences, Wuhan University Wuhan 430071 , China)
出处
《武汉大学学报（医学版）》
CAS
2018年第4期591-595,共5页
Medical Journal of Wuhan University
基金
国家自然基金重点仪器专项资助项目(编号:81227902)
国家重点研发专项(编号:2016YFC1304702)
关键词
肝癌
肝转移瘤
肝血管瘤
扩散峰度成像
Hepatic Carcinoma
Liver Metastases
Hepatic Hemangiomas
Diffusion Kurtosis Imaging
