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目的探讨扩散加权成像(diffusion-weighted imaging,DWI)及其表观扩散系数(apparent diffusion coeffi-cient,ADC)在胃良、恶性肿瘤鉴别中的价值,确定ADC值在良恶性肿瘤鉴别中的最佳临界点。方法 39例经手术或胃镜活检病理证实的胃肿瘤性病变患者,进行常规MRI及DWI,b值采用800 s/mm2,以病理结果为金标准,统计分析胃良性和恶性占位之间的ADC值差异。结果当b值为800 s/mm2,良性组ADC平均值为(2.200±0.959)×10-3mm2/s,恶性组ADC平均值为(1.89±0.463)×10-3mm2/s,两组间有显著差异(F=25.12,P<0.05)。受试者工作特征(ROC)曲线显示,区别良恶性胃部肿瘤的最佳临界点为1.915×10-3mm2/s,其敏感性为88.7%,特异性为91.1%,约登指数为0.798。结论 DWI在胃肿瘤诊断中具有可行性。b值为800 s/mm2时,胃良性和恶性肿瘤之间的ADC值存在显著统计学差异,区别胃部良恶性肿瘤的最佳临界点为1.915×10-3mm2/s,ADC值对于鉴别胃良恶性肿瘤有辅助诊断价值。
Objective To investigate the value of diffusion-weighted imaging (DWI) and apparent diffusion coeffi- cient (ADC) in the differential diagnosis of gastric benign and malignant tumors and to determine the value of ADC in differential diagnosis of benign and malignant tumors Good critical point. Methods Thirty-nine patients with gastric neoplasm confirmed by pathology or gastroscope biopsy underwent routine MRI and DWI. The b value was 800 s / mm2. The pathological results were taken as the gold standard. The ADC between benign and malignant gastric lesions Value difference. Results When the b value was 800 s / mm2, the average value of ADC in the benign group was (2.200 ± 0.959) × 10-3mm2 / s, and the average value of ADC in the malignant group was (1.89 ± 0.463) × 10-3mm2 / s Significant difference (F = 25.12, P <0.05). The receiver operating characteristic (ROC) curve showed that the best critical point for distinguishing benign and malignant gastric tumors was 1.915 × 10-3mm2 / s with a sensitivity of 88.7%, a specificity of 91.1% and a Youden index of 0.798. Conclusions DWI is feasible in the diagnosis of gastric cancer. ADC value of gastric benign and malignant tumors was significantly different at a b value of 800 s / mm2. The best cut-off point for distinguishing between benign and malignant gastric tumors was 1.915 × 10-3 mm2 / s, Benign and malignant tumors have diagnostic value.