DWI不同指数模型在肝细胞癌及肝血管瘤鉴别诊断中的应用价值

目的探讨弥散加权成像单指数模型、体素内不相干运动成像双指数模型及拉伸指数模型对肝细胞癌与肝血管瘤鉴别诊断的应用价值,并比较不同模型对两者鉴别的优越性。材料与方法回顾性分析66例行肝脏1.5 T MRI-DWI、e DWI、HB DWI序列患者资料,测量比较肝细胞癌和肝血管瘤单指数模型ADC值、Standard ADC值、双阶单指数模型D-mono、D*-mono、fmono值、双阶双指数模型D-Bi、D*-Bi、fBi值、HB DWI拉伸指数模型DDC、α值的差异。结果肝细胞癌和肝血管瘤组的ADC、Standard ADC、D-mono、D*-mono、fmono、D-Bi、D*-Bi、fBi值、DDC值差异均有统计学差异(P0.05)。ADC、Standard ADC、D-mono、fmono、D-Bi值ROC曲线下面积均大于0.9,Standard ADC值诊断效能优于ADC值(P0.05),D*-Bi、fBi、HB DDC诊断效能明显弱于ADC值(P0.05)。结论对于肝细胞癌及肝血管瘤两者鉴别,单指数模型ADC、Standard ADC,双指数模型D-mono、fmono、D-Bi值的诊断效能较好,其中多b值单指数模型Standard ADC值诊断效能相对优于传统单b值单指数模型ADC值。

Multiple exponential models of diffusion weighted imaging in differentiating hepatocellular carcinoma from hepatic hemangioma

Objective: To evaluate the feasibility of the monoexponential model of diffusion-weighted imaging (DWI), biexponential and stretched-exponential models of intravoxel incoherent motion (IVIM) and to compare the optimization in these models in differentiating hepatocellular carcinoma (HCC) from hepatic hemangioma (HH). Materials and Methods: Sixty-six patients under MR liver scanning were retrospectively enrolled in our hospital. All the patients were performed MRI exams on a 1.5 T scanner. For each region of interested (ROI), the mean values of DWI (ADC), eDWI (Standard ADC, D-mono, D*-mono, fmono, D-Bi、D*-Bi、fBi) and HB DWI (DDC, α) were measured. Results: The ADC, Standard ADC, D-mono, D*-mono, fmono, D-Bi, D*-Bi, fBi, DDC values of HCC and HH were statistically significant (P<0.05). The area under the ROC curve of ADC, Standard ADC, D-mono, fmono, D-Bi were higher than 0.9. The differential diagnostic efficiency with Standard ADC were significantly better than ADC. The differential diagnostic efficiency with ADC was significantly better than D*-Bi, fBi, HB DDC. Conclusions: The values of ADC, Standard ADC from monoexponential model, D-mono, fmono, D-Bi from double monoexponential model have favorable effective functions for the diagnosis, Standard ADC from monoexponential model with multiple b values were significantly better than ADC from monoexponential model with single b value in differential diagnosis of hepatocellular carcinoma and hepatic hemangioma.