Karaciğer Kitlelerinin Benign-Malign Ayrımında Difüzyon Ağırlıklı Sekansın Önemi

Amaç: Karaciğerin fokal kitlelerinin benign-malign ayrımında difüzyon ağırlıklı görüntülemenin ve görünen katsayı (ADC) değerlerinin tanıya katkısını araștırdık. Gereç ve Yöntem: Karaciğer kitlesi olan 34 hastaya kontrastlı inceleme öncesi difüzyon ağırlıklı MR görüntüleme sekansı uygulandı. 1,5 Tesla MR cihazında aksiyal planda, “single shot echoplanar spin” ile 3 farklı b değerinde (b=50, b=400, b=800 s/mm2) difüzyon gradiyentleri uygulanarak difüzyon ağırlıklı görüntüler elde edildi. ADC haritaları üzerinden ortalama 1 cm boyutunda ROI yerleștirilerek ortalama ADC değerleri belirlendi. Bulgular: Boyutu 1cm’den büyük olan 62 lezyon (46 benign,16 malign) değerlendirildi. 46 benign lezyonun ortalama ADC değeri 2.17±0.55 x 10-3 mm2/s (0,98 x 10-3 mm2/s - 2,65±0.54 x 10-3 mm2/s) ,16 malign lezyonun ortalama ADC değeri ise 0,84±0.40 x 10-3 mm2/s (0,14±0.01 x 10-3 mm2/s -1,32 x 10-3 mm2/s) idi. Sonuç: Fokal karaciğer kitlelerinin benign-malign ayrımında difüzyon ağırlıklı MR görüntüleme ve ADC değerlerinin karșılaștırılması ek bilgiler sağlamakta, özellikle IV kontrast veremediğimiz hastalarda ayırıcı tanıda bize yardımcı olmaktadır.

Anahtar Kelimeler:

Karaciğer kitlesi, Difüzyon ağırlıklı MR görüntüleme, ADC değeri

Karaciğer Kitlelerinin Benign-Malign Ayrımında Difüzyon Ağırlıklı Sekansın Önemi

Purpose: We investigated the diagnostic value of diffusion weighted imaging and apperent diffusion coefficient (ADC) mapping on differential diagnosis of benign and malignant focal liver masses. Materials And Metods: Diffusion - weighted MR imaging sequence was applied on 34 patients with a focal liver mass before contrast enhanced imaging. Diffusion - weighted images were obtained by applying 3 diffusion gradients at b level (b=50, b=400, b=800 s/mm2) with single shot echo-planar spin in axial plan in 1.5 Tesla MR tool. Average ADC values were determined by placing ROI at the size of 1 cm on average over ADC maps. Results: 62 lesions (46 benign, 16 malign) greater than 1 cm, in size were evaluated. Average ADC value of 46 benign lesions was 2.17±0.55 x 10-3 mm2/s and varied between (0,98 x 10-3 mm2/s 2.65 ± 0.54 x 10-3 mm2/s) and average ADC value of 16 malignant lesion was 0.84± 0.40 x 10-3 mm2/s (0.14 x 1010-3 mm2/s -1.32 x 10-3 mm2/s). Conclusion: Diffusion - weighted MR imaging and comparison of ADC values provide additional information in differentiating benign and malignant focal liver masses and particularly help us in differential diagnosis of patients to whom we cannot deliver IV contrast

Keywords:

Liver mass, Diffusion-weighted magnetic resonance imaging, ADC value,

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