目的 回顾性分析肝脓肿(HA)和坏死囊变性肝肿瘤(N-CHT)的磁共振扩散加权成像(DWl)与表观扩散系数(ADC)值的特点,探讨DWI和ADC值在HA和N-CHT鉴别诊断中的价值.方法 收集经证实的HA 20例,N-CHT 45例,行常规MRI及DWI检查,分别测量HA的脓腔、N-CHT的坏死囊变腔和正常肝组织(HT)平均ADC值.结果 HA的脓腔在DWI上18例表现为明显的高信号,2例为稍高信号,平均ADC值为(0.75 ±0.18)×10-3mm2/s;N-CHT的坏死囊变腔在DWI上40例表现为低信号,2例为稍高信号,3例为混杂信号,平均ADC值为(2.36±0.17)×10-3mm2/s,正常HT平均ADC值为(1.25 ±0.23) ×10-3mm2/s,HA的平均ADC值低于正常HT的ADC值(P＜0.01),N-CHT的平均ADC值高于正常HT的ADC值(P＜0.01).结论 综合分析HA的脓腔、N-CHT的坏死囊变腔DWI表现和ADC值,有助于HA与N-CHT的鉴别诊断.%Objective To investigate retrospectively the characteristics of DWI and ADC value about the hepatic abscess (HA) and necrotic-cystici hepatic tumors (N-CHT) .explore the value of DWI and ADC value to differentiation between HA and N-CHT. Methods 20 patients with HA and 45 patients with N-CHT which were verified were studied using conventional MRI scanning and DWI. The mean ADC values of the vomica with HA,the necrosis sac change cavity with N-CHT and normal hepatic tissue( HT)were measured,respectively. Results 18 patients with HA showed high signal intensity,2 cases displayed slight high signal intensity;40 patients with the N-CHT demonstrated low signal intensity,2 cases displayed slight high signal intensity,and 3 cases displayed mixed signal intensity on DWI. The mean ADC values of HA,N-CHT and HT were(0. 75 ± 0.18) × 10-3 mm2/s,(2.36±0. 17) × 10-3 mm2/s,( 1. 25 ±0. 23) × 10-3 mm2/s. The mean ADC values of HA is lower than HT(P<0.01) ,and the mean ADC values of N-CHT is higher than HT(P <0.01). Conclusion The DWI performance and ADC values of the vomica with HA and necrosis sac change cavity with N-CHT are comprehensively analysed. It can be helped with the differential diagnosis of the HA and N-CHT.
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