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利用MR动态增强扫描的定量参数探讨肝脏良恶性病灶不同区域血流灌注状态对肝脏良恶性占位鉴别诊断中的应用价值。采用MRI扫描仪对经临床证实肝脏占位性病变52例68个病灶进行动态增强扫描,在病变中央区及边缘绘制两个相同大小的ROI(region of interest),并分别测量定量血流灌注参数,如容量转移常数(Ktrans)、血管外细胞外间隙容积比(Ve)、速率常数(Kep)和血管空间容积分数(Vp),分析肝脏良恶性病灶中不同感兴趣区的MRI动态增强各定量参数之间的差异。肝脏良恶性占位中央区及边缘区的Ktrans及Kep值的差异具有统计学意义(P<0.05),肝脏良性占位中央区及边缘区的Ktrans及Kep值分别小于恶性占位的中央区及边缘区相应值。而肝脏良恶性占位病变之间中央区及边缘区的Ve及Vp值的差异不具有统计学意义(P>0.05)。恶性占位中央区与边缘区之间的Ktrans、Kep及Vp值的差异具有统计学意义(P<0.05),其边缘区的Ktrans、Kep及Vp值分别高于中央区相应值。而恶性肿瘤中央区与边缘区之间Ve值的差异不具有统计学意义(P>0.05)。良性占位中央区与边缘区之间DCE-MRI各参数值的差异不具有统计学意义(P>0.05)。DCE-MRI技术中的Ktrans、Kep定量参数能反映肝脏占位边缘区不同血流灌注特点,可对肝脏良恶性病变的诊断及鉴别诊断提供一定的参考信息。
To evaluate the value of perfusion of different regions of benign and malignant liver lesions in the differential diagnosis of benign and malignant liver lesions by quantitatively using dynamic contrast-enhanced MR imaging. Fifty-six lesions in 52 patients with clinically confirmed hepatic lesions were dynamically scanned using MRI scanner. Two ROIs of the same size were drawn in the central region and the periphery of the lesion. The quantitative perfusion parameters , Such as Ktrans, Ve, Kep and Vp, were used to analyze the dynamic enhancement of MRI in different regions of interest in benign and malignant liver lesions. The difference between the parameters. The difference of Ktrans and Kep between the benign and malignant lesions in the central and marginal areas was statistically significant (P <0.05). The Ktrans and Kep values in the central and marginal areas of the liver were less than those in the malignant lesions and The corresponding value of the marginal zone. There was no significant difference in Ve and Vp between the central and peripheral regions between benign and malignant liver lesions (P> 0.05). The Ktrans, Kep and Vp values between the central area and marginal area of malignant space occupancy were statistically significant (P <0.05). The Ktrans, Kep and Vp values of marginal area were higher than those of central area respectively. There was no significant difference in Ve between malignant tumors and the marginal zone (P> 0.05). There was no significant difference in DCE-MRI parameters between benign and central mass (P> 0.05). Ktrans and Kep quantitative parameters in DCE-MRI technique can reflect the characteristics of different perfusion in marginal zone of liver, which can provide some reference information for the diagnosis and differential diagnosis of benign and malignant liver lesions.