Objective To evaluate the diagnosis value of dynamic enhanced MRI and diffusion-weighted imaging ( DWI) on hepatic space occupying lesion. Methods 78 patients with hepatic space occupying lesion underwent the detection of MRI scan, dynamic enhanced MRI and DWI, and the enhanced categories were observed. Results The enhanced catego ries were of quick export and import types in 27 patients (87.1% ) with hepatocellular carcinoma, limbic circular enhancing in 22 patients (84.6% ) with hepatic metastasis tumor, gradual enhancing in 10 patients (90.9% ) with hepatic cavernous angio ma, and non-enhancing in 10 patients with hepatic cyst; there were no significant differences of apparent diffusion coefficients ( ADC) between hepatocellular carcinoma and hepatic metastasis tumor ( P > 0.05 ) , but the differences were significant be tween the two diseases and hepatic cavernous angioma and hepatic cyst (P 0.05). The aculracy of MRI plain scan, dynamic enhancement scan and DWI in diagnosis of hepatocelluar, hepatic metastasis tumor, hepatic carernons angioma and hepatic cyst was 96.8% , 96. 1% , 90.9% and 100% respectively. Conclusion MRI scan and dynamic enhanced MRI can provide routine diagnostic basis of hepatic space occupying lesion, and DWI has a high value in diagnosis of malignant disease.%探讨联合应用磁共振动态增强及弥散加权成像( DWI)对各种肝脏占位性病变的诊断及鉴别诊断价值.方法 对78例肝脏占位病变行常规MRI平扫及动态增强和DWI,观察各种肝脏占位性病变的强化类型.结果 本组27例(87.1％)肝细胞癌强化方式呈快进快出型,22例(84.6％)肝转移瘤呈边缘环形强化,10例(90.9％)肝脏海绵状血管瘤呈渐进性强化,10例肝囊肿动态增强病变未见强化；原发性肝细胞癌及肝脏转移瘤的表观扩散系数(ADC)值比较差异无统计学意义(P＞0.05),两者与肝脏海绵状瘤、肝囊肿ADC值比较差异均具有统计学意义(P＜0.05)；肝脏海绵状血管瘤与肝囊肿ADC值比较差异有统计学意义(P＜0.05).MRI平扫及动态增强结合DWI检查对肝细胞癌、肝转移瘤、肝脏海绵状血管瘤和肝囊肿的诊断准确性分别为96.8％,96.1％,90.9％和100％.结论 常规MR1平扫及动态增强扫描是诊断各种肝脏病变的基础,DWI对诊断良恶性病变有较高的价值.
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