目的分析VIBE技术和磁共振扩 散加权成像(DWI)对不典型肝血管瘤和肝 细胞癌的鉴别诊断价值。材料与方法 收 集2009年12月至2014年6月我院确诊的不 典型肝血管瘤6例，肝细胞癌10例。分析 VIBE动态增强不典型肝血管瘤和肝细胞 癌的影像表现，分析病变信号强度随b值 的改变的变化，结合病灶表观扩散系数 (ADC)值的大小鉴别不典型肝血管瘤和肝 细胞癌。结果 6例不典型血管瘤动脉期边 缘或中央结节样强化，门静脉期和延时期 其中1例周边环状强化，2例出现反相填 充，3例始终不填充。肝细胞癌呈不均匀 强化，3例为结节样强化，1例为不规则环 状强化。DWI中随b值增加，非典型肝血管 瘤信号衰减高于肝癌。不典型血管瘤ADC 值较肝细胞癌高，两者的差异有统计学意 义。结论 VIBE技术结合DWI可对不典型肝 血管瘤和肝细胞癌做出鉴别诊断，两者相 互结合，具有重要的临床指导意义。

Objective To study the diagnostic of VIBE technology and magnetic resonance imaging diffusion-weighted imaging(DWI) in atypical liver hemangioma and hepatocellulr carcinoma. Methods Six patients of atypical liver hemangioma and ten liver hepatocellulr carcinoma proved by my hospital were collected from December 2009 to June 2014. The imaging features of VIBE dynamic enhancement of atypical liver hemangioma and hepatocellulr carcinoma were analyzed. The changes of signal intensity with changes of b value of the lesions combined with the apparent diffusion coefficient value were analyzed to identified atypical liver hemangioma and hepatocellulr carcinoma. Results The lesions of six atypical liver hemangiomas had peripheral or central enhancement on the arterial phase. One of six atypical liver hemangiomas had peripheral ring enhancement on the portal venous phase and delayed phase, two of six had filling in opposite direction, three had not filling throughout. Ten hepatocellulr carcinomas showed heterogeneous enhancement, 3 cases of them had nodular enhancement, one irregular ring enhancement. The attenuation of signal intensity of atypical liver hemangiomas were higher than that of hepatocellulr carcinoma. The ADC value of atypical liver hemangiomas were higher than that of hepatocellulr carcinoma, and the difference between them was significant. Conclusion VIBE technology combined diffusion-weighted imaging can identify accurately atypical liver hemangioma and hepatocellulr carcinoma , which has important clinical guiding value.