DWI在胆囊壁增厚性病变中的诊断价值

目的 评价扩散加权成像(DWI)在胆囊壁增厚性病变中的诊断价值.方法 回顾性分析42例胆囊壁增厚性病变(16例胆囊癌和26例胆囊良性病变)的常规MRI及DWI图像,并由2位医师比较常规MRI、融合图像(DWI+T2WI)视觉评估、表观扩散系数(ADC)值的测量3种方法在判别胆囊壁增厚性病变良恶性的能力.结果 常规MRI、融合图像视觉评估、ADC值测量的受试者工作特征(ROC)曲线的曲线下面积(AUC)分别为0.570、0.849、0.901.常规MRI方法诊断的准确度、敏感性和特异性为59.5%、62.5%、57.7%;融合图像视觉评估的方法诊断的准确度、敏感性和特异性为85.7%、81.2%、88.5%;ADC值测量的准确度、敏感性和特异性为83.3%、80.0%、85.2%.胆囊癌组的平均ADC值[(1.15±0.35)×10-3mm2/s]明显低于胆囊良性病变组[(1.99±0.61)×10-3mm2/s](P<0.01).结论 DWI(融合图像的视觉评估和ADC值的测量)在胆囊壁增厚性病变良恶性质的判定中具有非常重要的价值.

The value of diagnosis and differential diagnosis of gallbladder wall thickening diseases with DWI

Objective To evaluate the usefulness of diffusion-weighted imaging(DWI) in the diagnosis and differential diagnosis of gallbladder wall thickening diseases.Methods 42 patients with gallbladder wall thickening (16 patients with carcinoma and 26 patients with benign lesion) were included in this study.All patients performed conventional MRI and DWI.The diagnostic performances of three methods (conventional MRI,visual assessment of color fusion image from DWI and T2WI,and ADC measurement) were evaluated by two radiologists.Results The area under the receiver operating characteristic curve were 0.570,0.849,0.901 for conventional MRI,visual assessment and ADC measurement respectively.The accuracy,sensitivity and specificity were 59.5%,62.5%,57.7% for conventional MRI,85.7%,81.2%,88.5% for visual assessment of color fusion image,and 83.3%,80.0%,85.2% for ADC measurement,respectivily.The mean ADC value of gallbladder cacinoma[(1.15±0.35)×10-3mm2/s]was significantly less than that of gallbladder benign lesion [(1.99±0.61)×10-3mm2/s](P<0.01).Conclusion The DWI(visual assessment of color fusion image and ADC measurement)might be a useful tool for diagnosis and differential diagnosis of the gallbladder wall thickening diseases.