擴散加權成像在鑒別肝細胞肝癌和周圍型膽管細胞癌中的價值

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本文關鍵詞：擴散加權成像在鑒別肝細胞肝癌和周圍型膽管細胞癌中的價值　出處：《臨床放射學雜志》2016年06期 　論文類型：期刊論文

【摘要】：目的探討擴散加權成像(DWI)在肝細胞肝癌和周圍型膽管細胞癌鑒別診斷中的價值。方法搜集經(jīng)病理證實的肝細胞肝癌患者30例和周圍型膽管細胞癌患者20例,均行b值為800 s/mm~2的DWI檢查,比較兩組表觀擴散系數(shù)(ADC)值、瘤/肝值之間的差異,以及腫瘤與鄰近肝實質之間的差異;采用受試者工作特征(ROC)曲線確定DWI對肝細胞肝癌和周圍型膽管細胞癌的診斷效能及二者鑒別的最佳ADC值和瘤/肝值臨界值。結果50例患者共54個腫瘤,所有腫瘤在DWI像上呈高信號,ADC圖像呈低信號。肝細胞肝癌和周圍型膽管細胞癌平均ADC值分別為(0.89±0.15)×10~(-3)mm~2/s和(1.05±0.14)×10~(-3)mm~2/s,二者差異有統(tǒng)計學意義(t=3.685,P0.01),二者ADC值均低于鄰近肝實質。肝細胞肝癌瘤/肝值低于周圍型膽管細胞癌瘤/肝值,二者差異有統(tǒng)計學意義(t=2.760,P0.01);ROC曲線確定ADC值和瘤/肝值診斷肝細胞肝癌和周圍型膽管細胞癌的臨界值分別為0.94×10~(-3)mm~2/s和0.83,敏感性和特異性分別為85%、70%和85%、60%,曲線下面積為0.783和0.732。結論DWI對肝細胞肝癌和周圍型膽管細胞癌的鑒別診斷具有一定的價值。
[Abstract]:Objective to investigate diffusion weighted imaging (DWI). Methods 30 cases of hepatocellular carcinoma and 20 cases of peripheral cholangiocarcinoma confirmed by pathology were collected. All patients were examined with DWI with b value of 800s / mm-2. The apparent diffusion coefficient (ADCC), tumor / liver value and the difference between tumor and adjacent hepatic parenchyma were compared between the two groups. Using the operating characteristics of the subjects (ROC). The diagnostic efficacy of DWI for hepatocellular carcinoma and peripheral cholangiocarcinoma and the optimal ADC value and tumor / liver critical value for differentiating them were determined. Results there were 54 tumors in 50 patients. All tumors showed high signal intensity on DWI images. The mean ADC values of hepatocellular carcinoma and peripheral cholangiocarcinoma were 0.89 鹵0.15) 脳 10 ~ (-3) mm ~ (-1) / s and 1.05 鹵0.14, respectively. 2 / s. The difference between the two groups was statistically significant (P 0.01). The ADC values of the two groups were lower than those of the adjacent hepatic parenchyma, and the value of HCC / HCC was lower than that of peripheral cholangiocarcinoma / liver cancer. The difference between them was statistically significant (P 0.01). The critical values of ADC value and tumor / liver value for the diagnosis of hepatocellular carcinoma and peripheral cholangiocarcinoma were 0.94 脳 10 ~ (-3) mm ~ (-1) / s and 0.83 脳 10 ~ (-3) mm ~ (-1), respectively. The sensitivity and specificity were 85% and 60%, respectively. The areas under the curve are 0.783 and 0.732.Conclusion DWI is valuable in the differential diagnosis of hepatocellular carcinoma and peripheral cholangiocarcinoma.
【作者單位】：安徽醫(yī)科大學第一附屬醫(yī)院影像科;安徽省太和縣人民醫(yī)院磁共振室;
【分類號】：R735;R445.2
【正文快照】： 磁共振擴散加權成像(diffusion weighted ima-ging,DWI)通過檢測生物組織內水分子狀態(tài)的改變而間接反映組織結構及細胞密度等信息,是目前唯一可以在分子水平對組織內水分子進行研究的功能成像方法。膽管細胞癌(cholangiocellular carcino-ma,CCC)是發(fā)生于膽管上皮的腺癌,是發(fā)

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