目的 探析DWI联合常规磁共振 成像在原发性肝癌治疗后随访中的应用 价值。方法 选择我院2012年1月-2015 年1月期间收治60例原发性肝癌患者作 为研究对象，分别于术前、术后1周及 术后1年对患者进行DWI联合常规磁共振 成像检查，记录术前、术后1周及术后1 年时不同b值所对应ADC值并进行比较， 总结原发性肝癌患者术后MR-DWI信号特 点，计算肿瘤复发灶检出率。结果 60 例原发性肝癌术前MR-DWI均示肿瘤呈高 信号，术后1周，DWI示碘油沉积区及肿 瘤坏死区为低信号，结合常规T2WI上肿 瘤坏死区为高信号，未沉积碘油肿瘤实 质部分则为高信号。术后1年， 50个复 发病灶共检测到48个，复发灶检出率为 96.0%(48/50)。26个新发病灶表现为高 信号。患者术后1周时不同b值所对应的 ADC值均高于术前，前后差异有统计学意 义(P＜0.05)；随访1年结束时，不同b值 所对应的ADC有所降低，均低于术后1周 的ADC，但依然高于术前，前后差异均有 统计学意义(P＜0.05)。结论 DWI联合常 规磁共振成像操作简单、成像快、无射 线损伤，可敏感显示肝癌病灶，在原发 性肝癌随访中的应用具有较高复发灶检 出率，利于术后随访期间复发情况的评 估，应用价值高。

Objective To study the application value of DWI combined with routine magnetic resonance imaging in the follow-up of patients with primary liver cancer after treatment. Methods 60 cases of patients with primary liver cancer treated in our hospital from January 2012 to January 2015 were treated as the research objects. DWI combined with routine magnetic resonance imaging was performed in 1 week before and after treatment and 1 year after operation. The ADC values of different corresponding b values were recorded and compared in 1 week before and after treatment and 1 year after operation. The characteristics of MR-DWI signal in patients with primary liver cancer after operation were summarized. The detection rate of recurrent tumor foci was calculated. Results MR-DWI of the 60 patients with primary liver cancer before operation showed high signals in tumors. 1 week after operation, DWI showed low signals in the lipiodol depositional areas and tumor necrosis areas. Combined with routine magnetic resonance imaging, it showed high signals in tumor necrosis areas on T2WI and high signals in non-depositional lipiodol solid parts of the tumors. 1 year after surgery, 48 recurrent lesions of the 50 ones were detected and the detection rate of recurrent lesions was 96% (48/50). 26 new lesions showed high signal. 1 week after operation, the ADC values of different corresponding b values were higher than those before operation (P<0.05). At the end of 1 year of follow-up, the ADC values of different corresponding b values decreased and were lower than the ADC values in 1 week after operation but they were still higher than those before operation (P<0.05). Conclusion DWI combined with routine magnetic resonance imaging is easy to operate, with fast imaging and without radiation injury. It can sensitively showed the lesions of liver cancer. The application in the follow-up of primary liver cancer is of higher detection rate of recurrent lesions, which is beneficial to evaluate the recurrence during postoperative follow-up. The application value is high.