摘要
背景与目的:肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)较少见,近年来发病率持续上升。本研究旨在探讨磁共振弥散加权成像(diffusion-weighted imaging,DWI)对ICC的诊断价值。方法:18例经手术病理证实ICC作常规磁共振成像及DWI成像(b=0,600 s/mm2),分析ICC常规影像特点,定量分析和比较ICC肿瘤实质区与正常肝组织、ICC中肝脓肿区与肿瘤坏死囊变区DWI信号特点及表观扩散系数差异。结果:18例病变T1WI均呈低信号,T2WI均呈较高信号,增强后早期强化多不明显,延迟期呈环状、向心性充填式强化。DWI图像上18例ICC肿瘤实质区均呈高信号,ADC值为(1.32±0.15)×1010-3mm2/s;正常肝实质区ADC值(1.54±0.15)×10-3mm2/s,3例肝脓肿区ADC值(0.09±0.04)×10-3mm2/s,7例肿瘤坏死囊变区ADC值(1.73±0.17)×10-3mm2/s。ICC肿瘤实质区与正常肝组织间、肝脓肿区与肿瘤坏死囊变区间ADC值差异均具有统计学意义(t=4.62,P<0.001,t=3.73,P<0.05)。结论:DWI可作为常规MRI诊断ICC的重要补充方法,并对ICC合并肝脓肿与肿瘤坏死区有鉴别意义。
Background and purpose： Intrahepatic cholangiocarcinoma （ICC） is a rare kind ofhepatocelluar carcinoma. In recent years, the incidence increased rapidly. This study aimed to evaluate the diffusion-weighted imaging （DWI） in diagnosing ICC. Methods： Eighteen cases with ICC proved by pathology underwent the routine, dynamic contrast-enhanced MRI （DCE-MRI） and DWI. The features of DCE-MRI and DWI were analyzed, the value of ADC between the tumor and the normal hepatic tissue, and between the abscesses and the necrotic part of the tumor were calculated. Results： Eighteen cases showed hypointensity in T1WI, hyperintensity in T2WI with gradual enhancement. In DWI images, 18 cases all showed hyperintensity with the value of ADC in the tumor region （1.32±0.15）× 10.3 mmZ/s vs the normal hepatic tissue （1.54±0.15）× 10.3 mm2/s. The value of ADC of the 3 abscesses and 7 necrosis of the tumor were （0.09±0.04）× 10.3 mm2/s and （1.73±0.17）× 10.3 mm2/s, respectively. There were all significant difference between each other （t=-4.62, P〈0.001, t=3.73, P〈0.05）. Conclusion： DWI is an important complementary approach to the routine and dynamic contrast-enhanced scanning in diagnosing ICC, and plays an important role in abscesses and necrosis of the tumor＇s differential diagnosis.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2012年第12期924-928,共5页
China Oncology
关键词
肝脏
胆管细胞癌
磁共振成像
扩散加权成像
表观扩散系数
Liver
Intrahepatic cholangiocarcinoma
Magetic resonance imaging
Diffusion-weightedimaging
Apparent diffusion coefficient
