CT灌注、MR灌注及MR扩散加权成像对肝脏疾病鉴别能力的比较

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摘要目的：比较CT灌注、MR灌注及MR扩散加权成像（DWI）对良恶性病变、肝硬化与正常肝脏的鉴别能力。方法：共50例进行DWI扫描、CT和MR灌注成像。包括：正常肝脏11例；肝硬化16例；肝脏恶性病变13例；肝脏良性病变10例。DWI扫描，计算各例肝脏或病灶的ADC值并进行组间比较。CT、MR灌注成像，以脾脏的峰值时间为界，分别计算脾脏峰值前后肝脏和病灶的曲线最大斜率，以脾脏峰值前后两个斜率的比值作为评估指标进行组间对比。记为SSr（ct）=SS前/SS后和SSr（mr）=SS前/SS后。结果：肝脏恶性病变、良性病变、肝硬化和正常肝脏4组的平均ADC值分别为（1.02±0.15）×10-3mm2/s、（2.21±0.74）×10-3mm2/s、（1.33±0.12）×10-3mm2/s、（1.50±0.11）×10-3mm2/s，除肝硬化和正常肝脏之间ADC值无统计学差异外，其余各组两两比较均有统计学差异（所有P<0.05）。恶性病变ADC值明显低于其他组，良性病变ADC值明显高于其他组。恶性病变组SSr（ct）和SSr（mr）测量结果分别为1.52±0.60和1.79±0.35，良性病变组分别为1.26±0.41和1.19±0.36，正常肝脏组为0.72±0.26和0.66±0.24；肝硬化组为1.38±0.39和1.83±0.59。良恶性病变组之间、良恶性病变组分别与肝硬化组之间以及良性病变组和正常肝脏组之间，组间比较SSr（ct）和SSr（mr）都无明显统计学差异（P>0.05）。肝硬化组，其测定的SSr（ct）和SSr（mr）结果与正常肝脏组均有显著差异（P<0.05）。结论：良恶性病变组之间、良恶性病变组分别与肝硬化组之间以及良性病变组和正常肝脏组之间，以ADC值互相鉴别较CT和MR灌注测量更有优势。在肝硬化的诊断方面CT、MR灌注较DWI更具优势。

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	史丽静
	李树平
	田建明
	陈炜
	汪剑

关键词 ：肝疾病, 体层摄影术, X线计算机, 磁共振成像

Abstract：Objective: To compare the differential diagnostic value of CT perfusion, MR perfusion and DWI in benign lesion, malignant lesion, cirrhosis and normal liver. Methods: Fifty cases underwent DWI, CT perfusion and MR perfusion, including 11 normal volunteers, 16 cirrhosis, 13 malignant liver lesions and 10 benign lesions. ADC value of each case was calculated and the results between the 4 groups were compared. When CT and MR perfusion was finished, separate the perfusion curve of liver lesion and hepatic parenchyma into two parts according to the TTP of spleen, calculate the SS of each part, then get the ratio of the two SS, named SSr(ct)=SSpre/SSpost to CT perfusion and SSr(mr)=SSpre/SSpost to MR perfusion. Then compare SSr(ct) and SSr(mr) between the 4 groups. Results: The ADC value of malignant lesion, benign lesion, cirrhosis and normal liver was(1.02±0.15)×10-3mm2/s, (2.21±0.74)×10-3mm2/s, (1.33±0.12)×10-3mm2/s and (1.50±0.11)×10-3mm2/s, respectively. The difference between each 2 groups were significant(P<0.05), except the result between cirrhosis and normal liver(P>0.05). The SSr(ct) and SSr(mr) of malignant tumors were 1.52±0.60 and 1.79±0.35, the results of benign lesions were 1.26±0.41 and 1.19±0.36, results of normal liver were 0.72±0.26 and 0.66±0.24, as to cirrhosis, the results were 1.38±0.39 and 1.83±0.59. The difference between each 2 groups were not significant(P>0.05), except the result between cirrhosis and normal liver, and the result between malignant tumors and normal liver(P<0.05). Conclusion: To different benign from malignant lesion, cirrhosis from those benign or malignant lesions, DWI may have more advantage than CT and MR perfusion, while CT and MR perfusion have more advantage in the diagnosis of cirrhosis.

Key words： liver diseases tomography X-ray computed magnetic resonance imaging

收稿日期: 2007-07-23

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引用本文:

史丽静;李树平;田建明;陈炜;汪剑. CT灌注、MR灌注及MR扩散加权成像对肝脏疾病鉴别能力的比较[J]. , 2007, 18(12): 884-888.
SHI Li-jing;LI Shu-ping;TIAN Jian-ming;CHEN Wei;WANG Jian. Comparison of the differential diagnostic value of CT perfusion, MR perfusion and DWI in liver diseases. , 2007, 18(12): 884-888.

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http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2007/V18/I12/884