ỨNG DỤNG TỶ LỆ HỆ SỐ KHUẾCH TÁN BIỂU KIẾN TRONG CHẨN ĐOÁN PHÂN BIỆT TỔN THƯƠNG GAN KHU TRÚ TRONG THỰC HÀNH LÂM SÀNG=The apparent diffusion coefficient ratio for discriminating benign and malignant lesions in clinical practice

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Tác giả: Cẩm Nhung Đặng, Ngọc Thành Hoàng, Trọng Bỉnh Lê, Thanh Thảo Nguyễn, Hồng Phương Dung Trần

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2024

Mô tả vật lý: tr.67-76

Bộ sưu tập: Metadata

ID: 487044

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Mục tiêu: Ứng dụng tỷ lệ hệ số khuếch tán biểu kiến (Apparent Diffusion Coefficient – ADC) cuả tổn thương so với gan và lách trong chẩn đoán phân biệt tổn thương gan lành tính và ác tính.Đối tượng và phương pháp nghiên cứu: 69 bệnh nhân có tổn thương gan khu trú tại Bệnh viện trường Đại học Y-Dược Huế từ 01/2023 đến 12/2023 được chụp MRI gan thường quy và chuỗi xung khuếch tán DWI với 3 giá trị b=50, b=400, b=800s/mm2. Các tổn thương được phân nhóm lành tính và ác tính dựa trên hình ảnh, kết quả giải phẫu bệnh và sinh hoá. Kết quả: Tuổi trung bình: 57 ± 14 tuổi, nam/nữ: 1.65. Nghiên cứu tổng cộng có 69 tổn thương, 20 lành tính và 49 ác tính. Giá trị trung bình tỷ lệ ADC tổn thương so với gan (ADC ratio1) và tỷ lệ ADC tổn thương so với lách (ADC ratio2) của các tổn thương lành tính cao hơn đáng kể so với các tổn thương ác tính, lần lượt là 1,86 so với 1,05 và 2,25 so với 1,47, p <
0,001. Giá trị điểm cắt tối ưu để phân biệt tổn thương lành tính với ác tính dựa trên ADCratio1 và ADCratio2 là 1,17 và 1,66, với độ nhạy lần lượt là 95% và 85%, độ đặc hiệu là 75,5% và 77,5%.Kết luận: Nghiên cứu này chứng minh sự khác biệt đáng kể về tỷ lệ ADC giữa hai loại tổn thương lành và ác tính, thiết lập các giá trị ngưỡng chẩn đoán cụ thể với độ nhạy và độ đặc hiệu cao để phân biệt.Objective: The primary aim was to assess the efficacy of Apparent Diffusion Coefficient (ADC) ratios in differentiating between benign and malignant liver lesions.Methods: A descriptive cross-sectional study of 69 patients was conducted from January 2023 to December 2023. Participants underwent standard MRI scans on Siemens 1.5-Tesla scanners using conventional sequences and diffusion sequences with b=50, b=400, and b=800s/mm2. Based on radiological features, histopathological findings, and biochemical tests, liver lesions were classified as benign or malignant.Results: The dataset comprised 69 lesions, 20 benign and 49 malignant lesions, with a median age of 57 ± 14 years a male/female ratio of 1.65. The average lesion to liver ADCratio1 and average lesion to spleen ADCratio2 of benign lesions were significantly higher than those of malignant lesions, 1.86 vs. 1.05 and 2.25 vs. 1.47, p <
0.001, respectively. Optimal cut-off values for ADCratio 1 and ADCratio 2 to differentiate between benign and malignant lesions were 1.17 and 1.66, respectively, resulting in sensitivities of 95% and 85% and specificities of 75.5% and 77.5%, respectively.Conclusion: This study demonstrates significant differences in ADC ratios between benign and malignant solid liver lesions, establishing specific cut-off values with high sensitivity and specificity for differentiation.

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