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目的探讨肝泡状棘球蚴病(hepatic alveolar echinococcosis,HAE)患者不同病灶区域磁共振弥散加权成像表观弥散系数(apparent diffusion coefficient,ADC)及动态增强扫描(dynamic contrast enhanced magnetic resonance imaging,DCE-MRI)参数差异,分析其在评估HAE边缘带增殖活性中的临床应用价值。方法 HAE患者35例,其中肝功能正常23例,肝功能异常12例,均行MRI常规T_1WI、T_2WI、磁共振弥散加权成像及DCE-MRI扫描,测量病灶实质、边缘带、周围肝实质ADC值,通过DCE-MRI时间信号曲线获得最大强化程度、最大相对增强率、流入速率、达峰时间。结果HAE病灶实质、肝功能正常组周围肝组织、边缘带ADC值依次减低[(1.57±0.14)×10~(-3) mm~2/s、(1.41±0.11)×10~(-3) mm~2/s、(1.03±0.13)×10~(-3) mm~2/s],两两比较差异均有统计学意义(P<0.05);肝功能正常组周围肝组织ADC值高于肝功能异常组[(1.03±0.14)×10~(-3) mm~2/s](P<0.05);除边缘带达峰时间与肝功能正常组周围肝组织比较差异无统计学意义(P>0.05)外,病灶实质、边缘带、周围肝组织肝功能正常组及肝功能异常组最大强化程度、流入速率、达峰时间和最大相对增强率比较差异均有统计学意义(P<0.05)。结论 ADC值及DCE-MRI半定量参数在HAE边缘带增殖活性评估中具有一定价值。
Objective To investigate the relationship between apparent diffusion coefficient (ADC) and dynamic contrast enhanced magnetic resonance imaging (DCE-DTPA) in different lesion areas of patients with hepatic alveolar echinococcosis (HAE) MRI) parameters, and to analyze its clinical value in assessing the proliferative activity of HAE marginal zone. Methods Totally 35 patients with HAE, 23 with normal hepatic function and 12 with abnormal hepatic function, underwent T_1WI, T_2WI, diffusion weighted imaging and DCE-MRI scans. The ADC values of the parenchyma, marginal zone and surrounding parenchyma were measured. The maximum enhancement, maximum relative enhancement, inflow rate and peak time were obtained by DCE-MRI time signal curve. Results The ADC values of the HAE lesion in the parenchyma of the liver and normal liver tissue were decreased in the order of [(1.57 ± 0.14) × 10 ~ (-3) mm ~ 2 / s, (1.41 ± 0.11) × 10 ~ (-3) (1.03 ± 0.13) × 10 ~ (-3) mm ~ 2 / s], with significant difference between every two groups (P <0.05). The ADC value of the liver tissue around the normal liver function group was high (1.03 ± 0.14) × 10 ~ (-3) mm ~ 2 / s] (P <0.05). There was no significant difference in the peak time of liver cirrhosis between the peak time and the normal liver function group (P> 0.05), there were significant differences in the maximal degree of enhancement, inflow rate, peak time and maximum relative enhancement between the normal liver tissue in the parenchyma, marginal zone and surrounding liver tissue and the liver dysfunction group (P < 0.05). Conclusion ADC value and semi-quantitative DCE-MRI parameters in the evaluation of the edge of HAE proliferative activity has some value.