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目的评估MR扩散加权成像(DW I)对经皮肝脏消融灶的组织成分进行定性的能力。方法对48例因肝脏局灶性病变接受消融治疗的患者行常规MR I和DW I,与组织病理学改变对照,观察消融灶的MR I表现,测量各组织成分在DW I中的信号值与ADC值。不同b值下各组织成分的ADC值均数行单因素方差分析比较,每2组间数据用单因素方差分析的Bonferroni法比较。结果常规MR I和DW I信号强度不能准确区分消融灶各组织成分,但信号强度有利于各成分ADC值测量的准确定位。在b值500 s/mm2,各成分ADC值为:消融凝固性坏死(0.44±0.21)mm2.s-1.10-3、肝充血(1.96±0.14)mm2.s-1.10-3、肉芽组织(2.28±0.24)mm2.s-1.10-3、存活肿瘤(1.24±0.08)mm2.s-1.10-3、肝脏(1.69±0.08)mm2.s-1.10-3,每2组数据间差异有统计学意义(F值为1280.49,多重比较每2组间均数差值为0.26~1.83,P<0.05)。结论DW I能对肝脏消融灶各组织成分定性,有希望提高MR I判断消融后局部疗效的准确性。
Objective To assess the ability of MR diffusion-weighted imaging (DWI) to characterize the tissue components of percutaneous liver ablation. Methods Forty-eight patients with focal hepatic lesions undergoing ablation were performed routine MR I and DW I, histopathological changes were compared with control to observe the MRI MRI performance of the lesions, the measurement of the tissue components in the DW I signal value and ADC value. The mean ADC value of each tissue component under different b values was compared by one-way ANOVA, and the data between two groups were compared by Bonferroni method using one-way ANOVA. Results Conventional MRI and DWI signal intensity can not accurately distinguish the tissue components of the lesion, but the signal intensity is conducive to the accurate positioning of the ADC value measurement of each component. The ADC values of each component were ablation coagulation necrosis (0.44 ± 0.21) mm2.s-1.10-3, liver congestion (1.96 ± 0.14) mm2.s-1.10-3, granulation tissue (2.28 ± 0.24) mm2.s-1.10-3, survival tumor (1.24 ± 0.08) mm2.s-1.10-3, and liver (1.69 ± 0.08) mm2.s-1.10-3, with significant difference between the two groups (F value of 1280.49, multiple comparison of the difference between each two groups was 0.26 ~ 1.83, P <0.05). Conclusions DWI can qualitatively identify the components of the tissue in the liver ablation area and hopefully improve the accuracy of MR I in determining the local efficacy after ablation.