论文部分内容阅读
目的分析体素内不相干运动扩散加权成像(IVIM-DWI)参数对肝脏肿瘤性质的鉴别诊断效果。方法选取2014年6月至2016年11月间新疆医科大学第二附属医院收治的68例肝脏肿瘤患者,均行常规磁共振成像平扫,磁共振THRIVE动态增强扫描及多b值(b=0、50、100、200、400、600、800、1000和1200s/mm2)扫描,DWI采用双指数模型获得慢速扩散系数(D)、快速扩散系数(D*)和快速扩散成分的百分比(f)。对不同肿瘤性质病人的D和D*值进行分析比较。结果良性肝脏肿瘤患者D值为(1.71±0.61)×10~(-3)mm~2/s,D*值为(22.1±18.6)×10~(-3)mm~2/s,f值为(34.1±23.8)×10~(-3)mm~2/s;恶性肿瘤患者D值为(1.05±0.41)×10~(-3)mm~2/s,D*值为(16.7±15.1)×10~(-3)mm~2/s,f值为(24.1±15.4)×10~(-3)mm~2/s。两组f值无明显差异,D值和D*值比较,差异均有统计学意义(均P<0.05)。参数D的曲线下面积、特异性、敏感性以及准确性均高于D*,差异均有统计学意义(均P<0.05)。结论 IVIM-DWI参数D和D*值能够有效提高肝脏肿瘤性质的鉴别诊断效果,为定性诊断提供可靠依据,其中,D值有助于更好的区分肿瘤性质。
Objective To analyze the differential diagnostic value of IVIM-DWI parameters in the diagnosis of hepatic tumors. Methods Sixty-eight patients with liver cancer admitted to the Second Affiliated Hospital of Xinjiang Medical University from June 2014 to November 2016 were enrolled in this study. All patients underwent conventional magnetic resonance imaging (MR) imaging, magnetic resonance imaging (THRIVE) dynamic contrast-enhanced scan and multiple b values , 50, 100, 200, 400, 600, 800, 1000 and 1200s / mm2). The DWI uses the double exponential model to obtain the slow diffusion coefficient (D), fast diffusion coefficient (D * ). The D and D * values of patients with different tumor types were analyzed and compared. Results The value of D was (1.71 ± 0.61) × 10 ~ (-3) mm ~ 2 / s and the value of D * was (22.1 ± 18.6) × 10 ~ (-3) mm ~ 2 / s in patients with benign liver tumors. (34.1 ± 23.8) × 10 ~ (-3) mm ~ 2 / s; the value of D was (1.05 ± 0.41) × 10 ~ (-3) mm ~ 2 / s in patients with malignant tumor and the value of D * 15.1) × 10 ~ (-3) mm ~ 2 / s, f value is (24.1 ± 15.4) × 10 ~ (-3) mm ~ 2 / s. There was no significant difference between the two groups of f values, D values and D * values, the differences were statistically significant (P <0.05). The area under the curve of parameter D, specificity, sensitivity and accuracy were higher than D *, the differences were statistically significant (P <0.05). Conclusion The IV and D values of IVIM-DWI can effectively improve the differential diagnosis of hepatic tumors and provide a reliable basis for the qualitative diagnosis. Among them, D value helps to better distinguish the nature of the tumor.