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• Clinical Article •
B value selection of diffusion-weighted MR imaging in differentiating malignant and benign liver lesions
LIU Wei  YANG Jun  SHAO Kang-wei  ZHU Cai-song  ZHU Ying  ZHAI Lu-lan  WANG Xiao-gang  GU Zhi-hong 

DOI:10.3969/j.issn.1674-8034.2011.04.009.


[Abstract] Objective: To evaluate the diagnostic value of diffusion-weighted imaging (DWI) in differentiating malignant and benign liver lesions by using different b values.Materials and Methods: Seventy-six consecutive patients with liver mass and eleven patients with liver cirrhosis were recruited and underwent CT and MR scans. DWI was performed on a 1.5 T MR scanner in all patients using three b values (300, 500, 700 s/mm2). Thirty normal patients were recruited as control group. Apparent diffusion coefficient (ADC) values of the mass were calculated on the workstation and compared between malignant and benign lesions using two independent sample Wilcoxon rank sum test.Results: 25 cases were diagnosed as malignant tumors including 13 cases of hepatocellular carcinoma, 10 cases of metastasis, 2 cases of cholangiocellular carcinoma; Fifty-one patients were diagnosed as benign lesions including 23 cases of cavernous hemangioma, 18 cases of cyst, 7 cases of abscesses, 3 cases of focal nodular hyperplasia. The ADC values and the ratio of ADC of lesion/liver parenchyma of malignant lesions were significantly lower than those of benign lesions (P<0.05). The sensitivity, specificity and accuracy were 71.4%, 80.6% and 76.9%, 95.0%, 78.1% and 73.1%, 90.0%, 77.5% and 77.5% respectively when b=300, 500 and 700 by using a threshold ADC of less than 1.60, 1.65, 1.41×10-3 mm2/s respectively. The sensitivity, specificity and accuracy were 60.0%, 81.8% and 73.6%, 65.0%, 86.1% and 78.6%, 75.0%, 94.9% and 88.1% respectively by using a threshold ADC ratio of lesion/liver less than 1.0. Liver abscesses had various ADC values ranging from 0.98 to 2.61×10-3 mm2/s.Conclusion: The ADC values and the ratios of ADC of lesion/liver parenchyma of malignant lesions were significantly lower than those of benign lesions. The differentiating diagnostic value is more effective when b=500 is used. But the ADC values were overlapping between the malignant and benign liver lesions. Liver abscesses had various ADC values and should be diagnosed by combining with clinical and laboratory examinations.
[Keywords] Liver tumour；Magnetic resonance imaging；Diffusion-weighted imaging；Apparent diffusion coefficient

LIU Wei* Department of Imaging, Changning District Central Hospital, Shanghai 200336, China

YANG Jun Department of Imaging, Changning District Central Hospital, Shanghai 200336, China

SHAO Kang-wei Department of Imaging, Changning District Central Hospital, Shanghai 200336, China

ZHU Cai-song Department of Imaging, Changning District Central Hospital, Shanghai 200336, China

ZHU Ying Department of Imaging, Changning District Central Hospital, Shanghai 200336, China

ZHAI Lu-lan Department of Imaging, Changning District Central Hospital, Shanghai 200336, China

WANG Xiao-gang Department of Imaging, Changning District Central Hospital, Shanghai 200336, China

GU Zhi-hong Department of Imaging, Changning District Central Hospital, Shanghai 200336, China

*Correspondence to: Liu W, E-mail: liuwei8186@sina.com

Conflicts of interest   None.

致谢： 本文数据处理得到了复旦大学临床流行病／循证医学中心马桂芬老师、陈世耀老师帮助。
Received  2010-06-26
Accepted  2011-02-06
DOI: 10.3969/j.issn.1674-8034.2011.04.009
DOI:10.3969/j.issn.1674-8034.2011.04.009.

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