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目的比较磁共振扩散加权成像(diffusion-weighted imaging,DWI)与T2加权成像(T2-weighted imaging,T2WI)对肝脏局灶性病变的检出效能。方法选择T2WI与DWI2种序列均进行了检查的57例患者共79个病灶(45个恶性,34个良性)纳入本次研究。2位读片者采用盲法分别阅读T2WI与DWI图像。第3位读片者测量病灶和邻近肝实质在DWI及T2WI上的信号强度,计算病灶/肝信号强度比(contrast ratios,CR)。比较2种序列之间检出率及CR值的差异。结果2种序列对恶性病灶的检出率之间的差异无统计学意义,T2WI对全部病灶和良性病灶的检出率高于DWI(2位读片者P<0.001)。对于恶性病灶,当在一种序列上检出病灶即计为检出时,则T2WI+DWI的检出率高于DWI(读片者1P=0.008,读片者2P<0.001),但与T2WI之间检出率的差异无显著性。共对46个病灶测量了CR。良性病灶的CR值在T2WI高于DWI(P=0.008),恶性病灶和全部病灶的CR值在2种序列之间的差异无统计学意义。结论DWI对恶性病灶的检出效能低于T2WI,对良性病灶的检出效能也不及T2WI。
Objective To compare the detection of focal hepatic lesions with diffusion-weighted imaging (DWI) and T2-weighted imaging (T2WI). Methods A total of 79 lesions (45 malignant and 34 benign) of 57 patients who underwent both T2WI and DWI sequences were included in this study. Two readers read the T2WI and DWI images blindly. The third reader measured the signal intensity of the lesion and adjacent liver parenchyma on DWI and T2WI and calculated the lesion / liver signal contrast ratio (CR). The differences in the detection rates and CR values between the two sequences were compared. Results There was no significant difference in the detection rate of malignant lesions between the two sequences. The detection rate of T2WI in all lesions and benign lesions was higher than that of DWI (P <0.001 for 2 readers). For malignant lesions, the detection rate of T2WI + DWI was higher than that of DWI when the lesion was detected in one sequence (reader 1P = 0.008, reader 2P <0.001), but not T2WI The difference between the detection rate was not significant. A total of 46 lesions were measured CR. The CR of benign lesions was higher than that of DWI at T2WI (P = 0.008). There was no significant difference in CR between malignant lesions and all lesions between the two sequences. Conclusion The detection of malignant lesions by DWI is less effective than that of T2WI. The detection of benign lesions is less effective than that of T2WI.