【摘要】 目的探讨PVTT和PVBT的MRI增强、DWI和ADC表现临床应用价值。方法报道27例门静脉癌栓和10例血栓患者。本组患者均作肝脏MRI平扫、DWI和ADC成像、多期或动态增强扫描。结果 PVTT和PVBT动脉期强化情况经X~2检验,X~2=33.0(P<0.01)。PVTT动脉期强化与其DWI高信号和ADC低信号表现kappa检验,kappa值分别为:0.4871、0.4876;PVBT动脉期无强化与其DWI稍高或等信号、与ADC等或稍高信号情况的kappa检验,kappa值分别为:0.6610、0.6610。PVTT和PVBT的ADC总体均值分别为(1.052±0.220)×10-3mm2/s和(1.439±0.356)×10-3mm2/s。结论 MRI增强时门静脉栓子强化是诊断PVTT和鉴别PVBT的重要征象,DWI和ADC表现对PVTT和PVBT的诊断和鉴别诊断具有一定参考价值。更多还原

【Abstract】 Objective To explore the usfull values of the findings of diffusion-weighted imaging( DWI) and apparent diffusion coefficient( ADC) in the portal vein tumor thrombus( PVTT) and portal vein blood thrombus( PVBT). Methods 27 cases with PVTT and 10 cases with PVBT were reported. The cases in two groups were made by non-enhancement,DWI,ADC and MRI multi-phase or dynamic contrast-enhanced MRI scan. Results X~2-test of number of within the branches of PVTT and that of PVBT in arterial phase enhancement were taken & X~2= 228. 6( P < 0. 01). The Kappa tests were made in the numenhancement within PVTT vesus high singal in DWI and low singal in ADC and Kappa values were 0. 4871 and 0. 4876,respectively. The Kappa tests were made in the noenhancement within PVBT vesus mild high singal in DWI and mild high or iso singal in ADC and Kappa values were 0. 6610 & 0. 6610,respectively. The overall average ADC value of PVTT and that of PVBT were( 1. 052 ± 0. 220)× 10-3mm2/ s and( 1. 439 ± 0. 356) × 10-3mm2/ s,respectively. Conclusion The portal venous thrombus enhanced of contrastenhancement MRI was a vital sign in diagnoses of PVTT in different from diagnoses in the PVBT and between the findings of DWI and ADC of PVTT and PVBT had a certain reference value for the diagnosis and differential diagnosis.更多还原