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1、醫(yī)學(xué)影像學(xué)雜志2014年第24卷第4期JMedImagingVo1.24No.42014DWI在鑒別診斷膀胱良惡性病變中的應(yīng)用價(jià)值陶靜,華佳,范瑜,路青,許建榮(上海交通大學(xué)醫(yī)學(xué)院附屬仁濟(jì)醫(yī)院放射科上海200127)【摘要】目的探討磁共振(magneticresonance,MR)彌散加權(quán)成像(diffusion—weightedimaging,DWI)中的表觀(guān)擴(kuò)散系數(shù)(apparentdiffusioncoefficient,ADC)及相對(duì)表觀(guān)擴(kuò)散系數(shù)(r-ADC)值在膀胱良惡性病變鑒別診斷中的應(yīng)用價(jià)值。方法共收集2012年1O月~2013年5月75例超聲診斷為膀胱占
2、位患者,并最終經(jīng)膀胱鏡病理確診。所有患者均行常規(guī)橫斷位TwI、TzwI、DWI(b值為0和1500s/mm。),橫斷位和冠狀位增強(qiáng)LAVA序列。測(cè)量病灶及病灶對(duì)側(cè)膀胱壁的ADC值及r-ADC值進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果所有惡性膀胱腫瘤病灶及4例良性病灶在DWI圖像上病灶顯示為明顯高信號(hào)。惡性膀胱腫瘤病灶平均ADC值(O.85±0.3O)×10mm/s明顯低于良性病灶的ADC值(1.624-0.86)×10。mm/s)(Pd0.05)。惡性腫瘤性病灶的r—ADC值(O.74±0.27)也明顯低于良性腫瘤性病灶(1.20±0.73)(Pd0.01)。結(jié)論結(jié)論DWI在鑒別膀胱良惡性
3、腫瘤中有較高的應(yīng)用價(jià)值,是一種較可靠的檢查方法。【關(guān)鍵詞】膀胱腫瘤;表觀(guān)擴(kuò)散系數(shù);彌散加權(quán)成像中圖分類(lèi)號(hào):R737.14;R445.2文獻(xiàn)標(biāo)識(shí)碼:A文章編號(hào):1006—9011(2014)O4一O571一O3Thedifferentialdiagnosisofmalignantandbenignbladderneoplasmusingdiffusion-weightedMRimagingTAOJing,HUAJia,F(xiàn)ANYu,LUQing,xUJian—rongDepartmentofRadiology,RenjiHospital,SchoolofNedicineSh
4、anghaiJiaotongUniversity,Shanghai200127,P.R.China[Abstract]ObjectiveThisstudyanalyzeddifferentialdiagnosticvaluebetweenmalignantandbenignbladderneoplasmbycomparingtheapparentdiffusioncoefficient(ADC)valuesandrelativeapparentdiffusiocoefficient(r-ADC)valuesondiffusion—weigyedMRimaging.Met
5、hodsBetweenOctober2012toMay2013,75consecutivepatients(52~76yearsold,mean60.4yearsold)whoweresuspectedhavingbladderneoplasmbyultrasoundexamsandfinallydiagnosedbycystosco—PYbiopsywereenrolledinthisstudy.AllpatientshadbeenperformedaseriessequencesofMRexaminationsincludingax—ialTlWI,TzWI,DW1
6、withbfactorsof0and1500s/mm,axialandcoronalGd—DTPAenhancedLAVAsequences.TheADCvaluesofthelesionsandthenormalbladderwal1weremeasuredandthenr-ADC(r—ADC=lesion'sADC/lateralwallsADC)valuewascalculated.Independent—samplesTTestwasappliedtoverifythesignificantdifferencesofADCandr_ADCvaluebetween
7、thebenignandthemalignantlesions.ResultsAllcaseswithmalignantlesionsand4caseswithbe—nignlesionswereappearedashighsignalintensity(SI)relativetobladderwallandthesurroundingurineonDWimages.ThemeanADCvalueofthemalignantbladderlesion(O.85-40.30)×10一。mm/swassignificantlowerthant