扩散加权成像在鉴别肝脏转移瘤和肝内胆管细胞癌中的价值

摘要

目的探讨扩散加权成像在肝脏转移瘤和肝内胆管细胞癌鉴别诊断中的价值。资料与方法经病理证实的肝脏转移瘤和肝内胆管细胞癌患者各13例，均行扩散加权成像（DWI）检查，比较两组表观扩散系数（ADC）值、瘤/肝值之间的差异，以及肿瘤与邻近肝实质之间的差异。结果26例患者共26个肿瘤，所有肿瘤在ADC图像上呈高信号，T1WI呈稍低信号，T2WI呈稍高信号，边界较清楚。肝脏转移瘤及肝内胆管细胞癌平均ADC值分别为（0.974±0.167）×10-3 mm2/s和（1.015±0.105）×10-3 mm2/s，二者差异无统计学意义（t=0.745, P>0.05）。肝脏转移瘤组瘤/肝值明显低于胆管细胞癌组（t=2.910, P<0.05）。肝内胆管细胞癌及肝脏转移瘤ADC值均低于邻近肝实质（t=8.323、6.043, P<0.05）。结论磁共振DWI中测得的瘤/肝值可为肝内转移瘤和肝内胆管细胞癌的鉴别诊断提供帮助。%Purpose To investigate the value of diffusion-weighted imaging (DWI) in the differential diagnosis of hepatic metastases and intrahepatic cholangiocarcinoma. Materials and Methods Thirteen patients with hepatic metastases and thirteen patients with intrahepatic cholangiocarcinoma confirmed by pathology were selected and underwent DWI, the differences in apparent diffusion coefficient (ADC) value, ratio of the tumors to liver and difference between tumors and adjacent liver tissues were compared. Results 26 lesions of 26 patients were observed, all showed high signal intensity on DWI and T2WI, and showed slightly low signal on T1WI. All lesions had clear margins. The ADC values of hepatic metastases and intrahepatic cholangiocarcinoma were (0.974±0.167)×10-3 mm2/s and (1.015±0.105)×10-3 mm2/s, respectively, with statistical difference (t=0.745, P>0.05), the ratio of tumors to liver of hepatic metastases was significantly lower than intrahepatic cholangiocarcinoma (t=2.910, P<0.05), the ADC values of hepatic metastases and intrahepatic cholangiocarcinoma were lower than that of adjacent liver tissue (t=8.323, 6.043;P<0.05). Conclusion The ratio of tumors to liver in DWI has an important value in the differential diagnosis of liver metastases and intrahepatic cholangiocarcinoma.