| IVIM-DWI鉴别诊断肝细胞癌和肝局灶性结节增生 |
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| 引用本文： | 何梦琪,许乙凯,张静,郑泽宇,雷李智,侯美蓉. IVIM-DWI鉴别诊断肝细胞癌和肝局灶性结节增生[J]. 中国医学影像技术, 2017, 33(6): 907-911 |
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| 作者姓名： | 何梦琪 许乙凯 张静 郑泽宇 雷李智 侯美蓉 |
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| 作者单位： | 南方医科大学附属南方医院影像中心, 广东 广州 510515,南方医科大学附属南方医院影像中心, 广东 广州 510515,南方医科大学附属南方医院影像中心, 广东 广州 510515,南方医科大学附属南方医院影像中心, 广东 广州 510515,南方医科大学附属南方医院影像中心, 广东 广州 510515,南方医科大学附属南方医院影像中心, 广东 广州 510515 |
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| 摘 要： | 目的 探讨体素内不相干运动扩散加权成像（IVIM-DWI）鉴别肝细胞癌（HCC）与肝局灶性结节增生（FNH）的价值。方法 对407例临床疑似HCC或FNH的患者行常规上腹部MR平扫、动态增强及IVIM-DWI扫描，60例患者（40例HCC，20例FNH）入组。IVIM采用单、双指数模型获得表观扩散系数（ADC）、慢速表观扩散系数（D）、快速表观扩散系数（D*）及快速扩散成分所占比例（f）。结果 FNH组的ADC、D、D*及f值分别为（1.60±0.25）×10-3mm2/s、（1.12±0.17）×10-3mm2/s、（44.89±18.23）×10-3mm2/s和（34.80±9.68）%；HCC组分别为（1.32±0.21）×10-3mm2/s、（0.82±0.21）×10-3mm2/s、（49.82±20.11）×10-3mm2/s和（28.72±13.84）%。2组间的ADC、D值差异有统计学意义（P均<0.001），而D*、f值差异无统计学意义（P>0.05）。D值相应ROC曲线下面积为0.90，以0.96×10-3mm2/s为阈值诊断HCC的敏感度、特异度分别为84.44%、90.02%。结论 IVIM-DWI有助于鉴别诊断HCC和FNH，其中双指数模型计算的D值诊断效能更高。
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| 关 键 词： | 体素内不相干运动 扩散磁共振成像 癌,肝细胞 局灶性结节增生 |
| 收稿时间： | 2016-11-21 |
| 修稿时间： | 2017-02-15 |
Evaluation of intravoxel incoherent motion DWI in differential diagnosis of hepatocellular carcinoma and focal nodular hyperplasia |
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| HE Mengqi,XU Yikai,ZHANG Jing,ZHENG Zeyu,LEI Lizhi and HOU Meirong. Evaluation of intravoxel incoherent motion DWI in differential diagnosis of hepatocellular carcinoma and focal nodular hyperplasia[J]. Chinese Journal of Medical Imaging Technology, 2017, 33(6): 907-911 |
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| Authors: | HE Mengqi XU Yikai ZHANG Jing ZHENG Zeyu LEI Lizhi HOU Meirong |
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| Affiliation: | Department of Medical Imaging, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China,Department of Medical Imaging, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China,Department of Medical Imaging, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China,Department of Medical Imaging, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China,Department of Medical Imaging, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China and Department of Medical Imaging, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China |
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| Abstract: | Objective To explore the feasibility of intravoxel incoherent motion DWI (IVIM-DWI) in differential diagnosis of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH). Methods A total of 407 patients with clinically-suspected HCC or FNH underwent conventional and dynamic enhanced MRI and IVIM-DWI, 60 patients (40 cases of HCC, 20 cases of FNH) were enrolled. Parameters of ADC, slow apparent diffusion coefficient (D), fast apparent diffusion coefficient (D*) and fraction of fast apparent diffusion coefficient (f) were obtained by monoexponential model and biexponential model respectively. Results The values of ADC, D, D* and f in FNH group were (1.60±0.25)×10-3 mm2/s, (1.12±0.17)×10-3 mm2/s, (44.89±18.23)×10-3 mm2/s and (34.80±9.68)%, and those in HCC group were (1.32±0.21)×10-3 mm2/s, (0.82±0.21)×10-3 mm2/s, (49.82±20.11)×10-3 mm2/s and (28.72±13.84)%, respectively. Significant inter-group differences were observed in ADC and D (both P<0.001), however, there were no significant differences in D* and f (both P>0.05). The areas under the ROC curve of D were 0.90, and taking D=0.96×10-3 mm2/s as cut-off value, the sensitivity and specificity of D in diagnosis of HCC were 84.44% and 90.02%. Conclusion IVIM-DWI is useful to distinguish FNH from HCC, and the D value in biexponential model has the best diagnostic efficacy for differentiations. |
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| Keywords: | Intravoxel incoherent motion Diffusion magnetic resonance imaging Carcinoma, hepatocellular Focal nodular hyperplasia |
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