Application Value Of The Combinaton Of IVIM And Chemical Shift Imaging In Differential Diagnosis Of Benign And Malignant Liver Tumors

Objective: combined use of 3.0 T magnetic resonance within the voxel irrelevant diffusion weighted imaging(Intravoxel incoherent motion,IVIM)and Chemical shift imaging(Chemical shift imaging,CSI),to explore the application value in differentiating benign and malignant liver tumors in the,provide better guidance for clinical treatment.Material and Methods :1.A total of 95 patients with liver occupying masses confirmed by histological biopsy or followed up from October 2018 to September 2019 were collected,including 23 cases of hepatic hemangioma,38 cases of hepatic cyst,24 cases of primary liver cancer and 10 cases of metastatic tumor.2.All cases were performed conventional MRI scan,IVIM DWI(b = 10,20,30,50,80,100,200,400,600,800,1000,2000,s/was)with reverse phase scanning and scanning imaging sequences,the Functool MADC post-processing software for solid tumors had the largest level and avoid the sac,vascular and bile duct line area and necrosis area of IVIM parameters,including the apparent diffusion coefficient(ADC)values,real diffusion coefficient(D),pseudo diffusion coefficient(D *)and the filling fraction(f value),At the same time,PACS post-processing software was used to select the signal intensity at the same level and the same antiphase of the lesion,and the changes of the signal intensity were calculated.3.SPSS17.0 software was used for statistical analysis of the data,and the measurement data were expressed as(mean ± standard deviation)(x±s).Independent sample t test was conducted for the parameters conforming to normal distribution.ROC curve was drawn to analyze the differential efficacy and threshold of ivim-dwi parameters for benign and malignant liver lesions.Results: in benign and malignant liver tumors,ADC,D and f values of the benign group were significantly higher than those of the malignant group(U = 218.50,t = 8.911,t = 5.006,all P < 0.05).There was no significant difference in D* values(U = 825.00,P >,0.05).ADC,D and f values of benign hepatic cyst were significantly higher than that of hepatic hemangioma(U = 30.00,P < 0.001).T =3.31,P < 0.005;T = 6.38,P < 0.001);There was no significant difference in D* values(U = 401.50,P >,0.05).However,D* values of malignant primary liver cancer and metastatic liver cancer showed statistically significant difference(U = 57.00,P < 0.05),while ADC,D and f values showed no statistically significant difference(P > 0.05).The signal indexes 1 and 2 in the malignant lesion group were significantly higher than those in the benign lesion group(t = 2.25,t = 3.05,all P < 0.05),while the signal indexes 3 were significantly lower than those in the benign lesion group(t =-2.15,P < 0.05).The area under the ROC curve(AUC)of D value was 0.903.When D value < 1.43mm2/s,the sensitivity was 85.2% and the specificity was 91.2%,indicating the best diagnostic performance.In addition,the AUC value increased to 0.97 after IVIM parameters were combined with chemical shift signals.Conclusion: the weighted imaging parameters ADC,D,f and chemical shift imaging have significant effects on the diagnosis and differentiation of benign and malignant liver tumors.Among the multiple parameters of ivim-dwi,D value can more reliably distinguish benign from malignant tumors.When IVIM parameters were combined with chemical shift signals,the ability to differentiate benign and malignant tumors was significantly improved.