High-b-Value Diffusion-Weighted MR Imaging of Hepatocellular Lesions: Estimation of Grade of Malignancy of Hepatocellular Carcinoma
High-b-Value Diffusion-Weighted MR Imaging of Hepatocellular Lesions: Estimation of Grade of Malignancy of Hepatocellular Carcinoma
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DOI：
10.1002/jmri.21931
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发表时间：
2009-11-01
影响因子：
4.4
通讯作者：
Araki, Tsutomu
中科院分区：
文献类型：
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作者：
Muhi, Ali;Ichikawa, Tomoaki;Araki, Tsutomu
目的：探讨弥散加权磁共振成像（DWI）对肝细胞癌恶性程度的判断价值。材料与方法：对73例患者进行动态对比增强计算机断层扫描（CE-CT）和DWI （b值，1000 s/mm(2)）。使用DW图像将病变分为可见和不可见。测量病变的表观扩散系数（ADC）。此外，通过动脉期CE-CT图像将病变分类为高血管或等低血管。比较各病变类型的影像学表现。结果：73例患者有98个肝细胞病变，其中组织学诊断为发育不良结节12例，高分化hcc 39例，中分化hcc 33例，低分化hcc 14例。中度低分化hcc和发育不良结节的平均ADC值（P < 0.00）。在DW图像上，90%的中度（30/33）和低分化hcc（13/14）可见，51%的高分化和hcc（20/39）和所有发育不良结节不可见。在22个等低血管病变中，4个在DW图像上可见，为低分化hcc，而18个不可见，为发育不良结节（12/18）或高分化hcc（6/18）。结论：DW图像上的低血管密度和可见性可以帮助区分低分化hcc和低级别肝细胞病变（发育不良结节和高分化hcc）。
Purpose: To evaluate the effectiveness of diffusion-weighted magnetic resonance imaging (DWI) in estimating the grade of mallignancy of hepatocellular carcinoma.Materials and Methods: Dynamic contrast-enhanced computed tomography (CE-CT) and DWI (b value, 1000 s/mm(2)) were performed on 73 patients. Using DW images the lesions were classified as visible or invisible. The apparent diffusion coefficient (ADC) of the lesions was measured. Furthermore the lesions were classified as hypervascular or iso-hypovascular using arterial phase CE-CT images. The image findings for each lesion type were compared.Results: The 73 patients had 98 hepatocellular lesions of which 12 were histologically diagnosed as dysplastic nodules 39 well differentiated HCCs 33 moderately differentiated HCCs and 14, poorly differentiated HCCs. The mean ADC values of moderately poorly differentiated HCCs and dysplastic nodules (P < 0.00). On DW images >90% of moderately (30/33) and poorly differentiated HCCs (13/14) were visible, while 51% of well-differentiated and HCCs (20/39) and all dysplastic nodules were invisible. Of 22 iso-hypovascular lesions 4 were visible on DW images and were poorly differentiated HCCs whereas 18 were invisible and were dysplastic nodules (12/18) or well-differentiated HCCs (6/18).Conclusion: A combination of hypovascularity and visibility on DW images can help distinguish poorly differentiated HCCs from low-grade hepatocellular lesions (dysplastic nodules and well differentiated HCCs).