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目的:探讨多b值DWI在肝脏常见占位性病变鉴别诊断中的应用价值。方法:选取经临床证实肝脏占位性病变48例62个病灶行多b值的DWI扫描,分别拟合出10个b值ADC_(10b)图,3个低b值(0s/mm~2、50s/mm~2、100s/mm~2)ADClow图,3个高b值(500s/mm~2、750s/mm~2、1000s/mm~2)ADC_(high)图,并将ADC_(low)与ADC_(high)值之间的差异定义为ADC_(perf)值。在病变中央区及边缘区绘制两个相同大小的ROI(region of interest),分别计算ADC_(low)、ADC_(high)、ADC_(perf)、ADC_(3b)及ADC_(10b)值,分析肝脏良恶性占位及病变中央区及边缘区各ADC值之间的差异。结果:良恶性占位之间其中央区和边缘区在灌注(ADC_(perf))图上ADC值的差异均有统计学意义(P<0.05),病变中央区及边缘区之间良恶性占位在ADC_(perf)图上ADC值的差异有统计学意义(P<0.05);除了在ADC_(low)外,其余ADC_(10b),ADC_(high),ADC_(3b)图上良恶性占位之间中央区及边缘区ADC值的差异均有统计学意义(P<0.05),恶性肿瘤中央区与边缘区ADC值的差异均有统计学意义(P<0.05)。而良性占位中央区及边缘区ADC值差异,除了在ADC_(low)外,均无统计学意义(P>0.05)。结论:多b值DWI技术可提供肝脏占位血流灌注特点的参考信息,与其他MRI成像序列相结合,能够提高肝脏占位性病变的诊断及鉴别诊断准确率。
Objective: To investigate the value of multi-b value DWI in the differential diagnosis of common liver space occupying lesions. Methods: Forty-two DWI scans of 62 lesions of liver space-occupying lesions were selected and 10 b values ADC 10b images were obtained. Three low b values (0s / mm ~ 2, ADClow graphs of three high b values (500s / mm ~ 2,750s / mm ~ 2, 1000s / mm ~ 2) ) And the ADC_ (high) value is defined as the ADC_ (perf) value. Two ROIs of the same size were plotted in the central and peripheral regions of the lesion, and ADC_ (low), ADC_ (high), ADC_ (perf), ADC_ (3b) and ADC_ (10b) Differences between ADC values of benign and malignant masses and lesions in the central and peripheral regions. Results: There was a significant difference in ADC value between perfusion (ADC_ (perf)) and benign and malignant lesions in benign and malignant lesions (P <0.05). The benign and malignant lesions in the central and peripheral regions The differences of ADC values between the ADC_ (perf) maps and the ADC_ (perf) maps were statistically significant (P <0.05). Except for ADC_ (low), the others of the ADC_ (10b), ADC_ (high) and ADC_ (3b) There were significant differences in ADC values between the central and marginal zones (P <0.05), and between the central and marginal zones of malignant tumors (P <0.05). There was no significant difference in ADC values between the central and peripheral regions of benign masses except ADC_ (low) (P> 0.05). Conclusion: The multi-b value DWI technique can provide the reference information of the characteristics of hepatic space-occupying blood perfusion. Combining with other MRI imaging sequences can improve the accuracy of diagnosis and differential diagnosis of liver space-occupying lesions.