【摘要】 目的 通过对伴肝硬化的临床诊断或可疑小肝癌患者进行MR扩散加权成像（DWI）及多期增强扫描,研究DWI及ADC值对小肝癌的检出敏感性,得出诊断小肝癌的ADC最佳界值。方法 42例临床诊断或怀疑小肝癌患者进行DWI和多期增强扫描,DWI采用b值0,800 s/mm²。根据病灶DWI后的图像测量ADC值并进行统计学分析。结果 DWI、T₁WI、T₂WI序列对肝脏小病灶的检出率分别为94.34%、79.25%、83.02%。小肝癌的ADC值小于肝硬化实质和良性病变的ADC值,且它们之间差异有统计学意义（P值分别为0.005和0.017）。当诊断良恶性的ADC临界值设为1.176×10^-3 s/mm²时,敏感度为70%,特异度为81.2%。结论DWI对肝脏病变的检出率高于常规T₁WI和T₂WI。小肝癌的ADC值小于良性病变,ADC值有助于良恶性的诊断。更多还原

【Abstract】 Objective To evaluate the sensitivity of diffusion-weighted MR imaging（DWI） and explore the clinical threshold of apparent diffusion coefficient（ADC） values in diagnosis of small hepatocellular carcinoma（SHCC） in patients with cirrhosis using DWI and MR dynamic scanning.Methods Forty-two patients with confirmed small hepatocellular carcinoma or suspicious small hepatocellular carcinoma patients underwent CT scan,CT perfusion imaging,DWI and MR dynamic scanning.The DWI was performed with different b value（0,800 s/mm²）.The ADC values of all lesions were calculated and analyzed.Results The detection sensitivities of DWI,T₁WI and T₂WI were 94.34%,79.25%,83.02% respectively and the mean ADC values of SHCC,cirrhotic liver parenchyma and benign lesion were（1.071±0.248）×10^-3 s/mm²,（1.185±0.273）×10^-3 s/mm²,（1.490±0.562）×10^-3 s/mm² respectively.There was statistically significant difference in ADC value between SHCC lesions and cirrhotic liver parenchyma,SHCC lesions and benign lesion（P=0.005,P=0.017）.When the ADC critical diagnosis value of benign and malignant lesion was set at1.176×10^-3 s/mm²,the sensitivity and specificity reached 70% and 81.2 % respectively.Conclusion The detection sensitivity of DWI is higher than those of T₁WI and T₂WI.DWI and ADC value can provide important information for detection and diagnosis of SHCC.更多还原