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目的讨论弥散加权成像(DWI)及其表观弥散系数(ADC)对小肝癌的诊断价值。方法54例疑诊小肝癌患者同时行常规MRI和DWI检查,获得小肝癌病灶和硬化结节病灶的ADC值,并通过ROC曲线分析ADC最佳临界值及诊断敏感度和特异度。结果54例患者共发现病灶61个,其中手术或病理确诊为小肝癌41个,长期随访证实为硬化结节20个。DWI表现示,41个小肝癌病灶为高信号36个,稍高信号5个;20个硬化结节病灶低信号16个,等信号者4个。小肝癌病灶ADC值低于硬化结节病灶[(1.26±0.18)×10~(-3)s/mm~2 vs.(1.50±0.34)×10~(-3)s/mm~2](P<0.05)。ADC临界值取1.51×10~(-3)s/mm~2时DWI诊断小肝癌敏感度为100%,特异度为50%。结论 DWI及其ADC值对小肝癌的检出和诊断具有一定价值。
Objective To investigate the diagnostic value of diffusion weighted imaging (DWI) and its apparent diffusion coefficient (ADC) in small hepatocellular carcinoma. Methods 54 patients with suspected small hepatocellular carcinoma were examined with conventional MRI and DWI simultaneously. ADC values of small hepatocellular carcinoma and sclerosing nodules were obtained. The optimal cutoff value and sensitivity and specificity of ADC were analyzed by ROC curve. Results A total of 61 lesions were found in 54 patients, of which 41 were diagnosed as small hepatocellular carcinoma by surgery or pathology and 20 as sclerotic nodules in long-term follow-up. DWI showed that 41 small hepatocellular carcinoma lesions were high signal 36, slightly higher signal 5; 20 sclerosis nodules low signal 16, such as signal 4. The ADC value of small hepatocellular carcinoma was lower than that of sclerotic nodules [(1.26 ± 0.18) × 10 ~ (-3) s / mm ~ 2 vs. (1.50 ± 0.34) × 10 ~ (-3) s / mm ~ P <0.05). When the threshold value of ADC was 1.51 × 10 -3 s / mm ~ 2, DWI had a sensitivity of 100% and a specificity of 50%. Conclusions DWI and ADC value have some value in detecting and diagnosing small hepatocellular carcinoma.