简介：

简介：Objective:Toassessifdiffusion-weightedmagneticresonance(MR)imagingwithoutapparentdiffusioncoefficient(ADC)valuesprovidesaddeddiagnosticvalueincombinationwithconventionalMRimaginginthedetectionandcharacterizationofsmallnodulesincirrhoticliver.Methods:Twoobserversretrospectivelyandindependentlyanalyzed86nodules(≤3cm)certifiedpathologicallyin33patientswithlivercirrhosis,including48hepatocellularcarcinoma(HCC)nodules,13high-gradedysplasticnodules(HDN),10low-gradedysplasticnodules(LDNs)and15otherbenignnodules.AllthesefocalnoduleswereevaluatedwithconventionalMRimages(T1-weighted,T2-weightedanddynamicgadolinium-enhancedimages)andbreath-holddiffusion-weightedimages(DWI)(b=500s/mm2).Thenoduleswereclassifiedbyusingascaleof1-3(1,notseen;3,wellseen)onDWIforqualitativeassessment.Thesesmallnoduleswerecharacterizedbytworadiologists.ADCvaluesweren’tmeasured.ThediagnosticperformanceofthecombinedDWI-conventionalimagesandtheconventionalimagesalonewasevaluatedusingreceiveroperatingcharacteristic(ROC)curves.Theareaunderthecurves(Az),sensitivityandspecificityvaluesforcharacterizingdifferentsmallnoduleswerealsocalculated.Results:Among48HCCnodules,33(68.8%)weregradedas3(wellseen),6(12.5%)weregradedas2(partiallyobscured),and9weren’tseenonDWI.Among13HDNs,therewere3(23.1%)and4(30.8%)gradedas3and2respectively.Five(50%)of10benignnoduleswerepartiallyobscuredandslightlyhyperintense.For86nodules,theaveragediagnosticaccuracyofcombinedDWI-conventionalimageswas82.56%,whichwasincreasedsignificantlycomparedwithconventionalMRimageswith76.17%.ForHCCandHDN,thediagnosticaccuracyofcombinedDWI-conventionalimagesincreasedfrom78.69%to86.07%.Conclusions:Diffusion-weightedMRimagingdoesprovideaddeddiagnosticvalueinthedetectionandcharacterizationofHDNandHCC,anditmaynotbehelpfulforLDNandregenerativenodule(RN)incirrhot