关键词: 肝癌, 肝良性占位, 磁共振成像, 扩散加权成像, 肝脏三维容积快速多期动态增强技术, 表观扩散系数

Abstract: Objective To explore the application of multi-b-value diffusion weighted imaging （DWI） sequence and apparent diffusion coefficient（ADC） combined with three-dimensional volumetric rapid liver multiphase dynamic enhancement technology（LAVA） in the differential diagnosis of benign and malignant liver tumors. Methods 80 patients with hepatic lesions（124 lesions） were examined by T1WI,T2WI routine scanning,and DWI （b=0,50,100,150,200,250,300,500,750 and 1000s / mm²,respectively）,and we found out 124 lesions out of these patients including hepatic angeioma in 17 （27 lesions） and hepatic cyst in 23（31 lesions）,as well as hepatic metastasis in 14（23 lesions） and hepatocellular carcinoma in 26 （43 lesions）. Results 31（72.1%） lesions of hepatocellular carcinoma showed“rapid in and rapid out” enhancement,19（82.6%） metastatic lesions showed strengthened annular edge,21（77.8%） hemangioma showed “filling style”enhancement,31 cystic lesions were without enhancement;the ADC10b,ADChigh and ADC3b in benign lesions were significantly higher,while the ADCperf in benign lesions was significantly lower than those in malignant tumors （P<0.05）;the detection of lesions by routine T1WI,T2WI and DWI scanning,or conventional T1WI,T2WI scanning and LAVA,or routine T1WI,T2WI scanning,DWI LAVA was 100%,but the accuracy was significant different（P<0.05）,e.g. the highest（92.7%） by routine T1WI,T2WI scanning,DWI LAVA,in the middle（83.9%） by conventional T1WI,T2WI scanning and LAVA,and the lowest（71.8%） by routine T1WI,T2WI and DWI scanning. Conclusion The ADC10b,ADChigh,ADC3b and ADCperf can distinguish benign and malignant lesions,LAVA can clearly show the characteristics of blood supply of liver lesions at different periods,and both DWI and LAVA technology can improve the diagnosis of hepatic lesions.

Key words: Hepatic neoplasmas, Diffusion-weighted imaging, Liver multiphase dynamic three-dimensional volumetric rapid enhancement technology, Apparent diffusion coefficient