Share：
Share this content in WeChat
X
[Chinese][PDF]74270
• 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.

[1]
Naminoto T, Yamashita Y, Sumi S, et al. Focal Liver Masses: characterization with diffusion-weighted echo-planar MR imaging. Radiology, 1997, 204(3): 739-744.
[2]
郑晓林，徐辉雄，吕明德，等．扩散加权MRI定性诊断肝脏局灶性病变的研究．中华放射学杂志, 2005, 39(2): 173-176.
[3]
祝新,王德行,朱斌,等. SENSE基础上扩散加权成像诊断肝脏占位性病变的价值.放射学实践, 2005, 20: 377-380.
[4]
马军.解读ANN发布的《DWI和PWI在缺血性卒中的诊断价值-循证指南》.磁共振成像, 2010, 1(5): 324-329.
[5]
黄丙仓,詹松华,耿道颖,等.大鼠右肝门静脉结扎磁共振扩散加权成像.磁共振成像, 2010, (1): 55-59.
[6]
Girometti R, Furlan A, Esposito G, et al. Relevance of b-values in evaluating liver fibrosis: a study in healthy and cirrhotic subjects using single-shot spin-echo echo-planar diffusion-weighted sequences. J Magn Reson Imaging, 2008, 28(2): 411-419.
[7]
Taouli B, Vilgrain V, Dumont E, et al. Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. Radiology, 2003, 226(1): 71-78.
[8]
Kim SY, Lee SS, Byun JH, et al. Malignant Hepatic Tumors: Short-term Reproducibility of Apparent Diffusion Coefficients with Breath-hold and Respiratory-triggered Diffusion-weighted MR Imaging. Radiology, 2010, 255(3): 815-823.
[9]
Taouli B, Koh D-M. Diffusion-weighted MR Imaging of the Liver. Radiology, 2010, 254(1): 47-66.
[10]
Parikh T, Drew SJ, Lee VS, et al. Focal Liver Lesion Detection and Characterization with Diffusion-weighted MR Imaging: Comparison with Standard Breath-hold T2-weighted Imaging. Radiolgy, 2008, 246(3): 812-822.
[11]
Bruegel M, Holzapfel K, Gaa J, et al. Characterization of focal liver lesions by ADC measurements using a respiratory triggered diffusion-weighted sigle-shot echo-planar MR imaging technique. Eur Radiol, 2008, 18(3): 477-485.

PREV Prelimary study of lumbar intertebral disc degeneration with magnetic resonance spectroscopy, T2 relaxation times and apparent diffusion coefficient
NEXT Metabolic changes of liver cell apoptosis: an in vivo 1H magnetic resonance spectroscopy study
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn