【摘要】 目的探讨MR扩散加权成像(DWI)及表观扩散系数(ADC)值在可疑小肝癌(SHCC)鉴别诊断中的应用价值。方法应用高场MRI对100例可疑SHCC者同时行常规MRI和DWI检查,通过分析ADC值,并将小肝癌与非SHCC的ADC值进行ROC曲线分析,以确定诊断可疑小肝癌的合适ADC值。结果 100例可疑SHCC患者经手术病理或随访确诊为SHCC者66例,非SHCC34例,其中退变结节19例,肝血管瘤15例。DWI、T1WI和T2WI对SHCC的检出率分别为97.3%(71/73)、89.04%(65/73)、86.3%(63/73)。66例SHCC患者的ADC均值为(0.934±0.138)×10-3mm2/s,显著低于非SHCC患者的ADC值[(1.450±0.436)×10-3mm2/s](t=15.03,P<0.001)。当ADC诊断界值设为≤1.21×10-3mm2/s时,敏感性为82.35%,特异性为93.24%,准确性为85.29%。结论 DWI对SHCC的检出率高于常规T1WI和T2WI,SHCC的ADC值小于非SHCC的ADC值,DWI及ADC值在可疑SHCC的鉴别诊断中具有临床应用价值。更多还原

【Abstract】 Objective To investigate the application of diffusion-weighted imaging and apparent diffusion coefficient(ADC) values in the diagnosis of suspicious small hepatocellular carcinoma.Methods A total of 100 patients with suspicious small hepatocellular carcinoma(SHCC) were enrolled in this study. Both routine MRI and DWI scanning were performed in all patients.The apparent diffusion coefficient(ADC) values were statistically analyzed, and the receiver operating curve(ROC) analysis was used to evaluate the ADC values of SHCC and non-SHCC in order to determine the cutoff point of ADC values for the diagnosis of SHCC.Results Of 100 patients with suspicious small hepatocellular carcinoma,pathologically-proved SHCC was found in 66 SHCC and non-SHCC in 34,including dysplastic nodule(n=19) and hemangiomas(n=15).The detection rates of DWI,T1 WI and T2 WI for SHCC were 97.26%(71 /73),89.04%(65 /73) and86.3%(63 /73) respectively.The mean value of ADC in 66 SHCC patients was(0.934 ± 0.138) × 10- 3mm2/s,which was significantly lower than that in non-SHCC patients,that was(1.450 ± 0.436) × 10- 3mm2/s(t=15.03,P < 0.001).When the cutoff point of ADC value was set at ≤1.21 × 10- 3mm2/s,the sensitivity,specificity and accuracy for SHCC was 82.35%, 93.24% and 85.29%,respectively.Conclusion The detection rate of DWI is higher than that of T1 WI and T2 WI for the diagnosis of SHCC.The mean ADC value of SHCC is lower than that of non-SHCC.DWI and ADC have clinical application value in the diagnosis of suspicious small hepatocellular carcinoma.更多还原