간세포암 환자의 확산강조영상검사 시 조영제 주입 전·후 현성확산계수의 변화에 대한 연구

Purpose : It is the purpose of the study to investigate what value variation of the apparent diffusion coefficient (ADC) is appearing before and after the injection of the contrast agent, transforming b-value by using the free breathing technique on the benign and malignant liver lesion patients before the operations, and to find whether it is useful for the material of confirming malignant tumors. Materials and Methods : This is retrospective and was conducted by the permission of the Institutional Review Board (IRB) ; The research was kept on from November 1, 2015 to January 31, 2016, and a total of 38 patients who visited during that period the hospital of P university located in Pusan and was requested to receive the liver MRI examination were selected as the objects of the study. The protocol used in the study is the optimized technique for the liver test which is conducting in the hospital ; The axial plane diffusion-weighted image before the injection of the contrast agent was acquired by the free breathing technique and it was repeatedly done during the 20 minute delay after the injection of PRIMOVIST 10 ml. With the used diffusion weighted image the test was conducted by dividing b-values in detail 50, 500, 800, 1000 s/mm2, using the SE echo single-shot EPI. In case of the quantitative evaluation the Image J program and the work station were used for the evaluation, and ADC map was made according to the subdivided b-values; With it the apparent diffusion coefficient was calculated by establishing the ROI (region of interest). the statistical analysis was used the paired T-test ; When it was p 0.05). In case of liver metastatic caner : pre ADC (500, 800, 1000: 1.450, 1.472, 1.332 × 10-3 s/mm2), post ADC (500, 800, 1000: 1.438, 1.441, 1.354 × 10-3 s/mm2) (p> 0.05). In case of hemangioma as a benign tumor : pre ADC (500, 800, 1000: 1.591, 1.365, 1.217 × 10-3 s/mm2) and post ADC (500, 800, 1000: 1.906, 1.614, 1.396 × 10-3 s/mm2) (p>0.05). Conclusions : In case of benign tumors, any meaningful correlation was not found in the results before and after the injection of the contrast agent, and there was no regularity. However, in case of the malignant lesion (LR-5), the apparent diffusion coefficient after the injection of the contrast agent was lower than that of the benign lesion, which was statistically significant and increased the signal intensity of the lesion only to bring the enhancement of the qualitative analysis. As suggested in the study, in case of the diffusion weighted image of abdomen, it would be better to combine the diffusion weighted images before and after the injection of the contrast agent, because result value of the apparent diffusion coefficients and the accuracy of the diffusion weighted images could be differently measured. In addition, if the apparent diffusion coefficients after the injection of the contrast agent and the available pulse sequence could be combined, the efficiency for the diagnosis of the benign diseases or the maglinant diseases would be increasing