目的探讨磁共振动态增强扫描 (DCE-MRI)与弥散加权成像(DWI)对肝脏 局灶性结节性病变的诊断价值。方法 选 取我院2016年9月-2017年12月肝脏局灶 性结节性病变患者80例，其中肝血管瘤 20例，肝脏转移瘤26例，原发性肝癌34 例，均接受DWI及DCE-MRI检查，分析不 同肝脏局灶性结节性病变ADC值及PV、 MSD、PEI、SER、MSI、病变动态增强扫 描曲线类型，并对比单独应用DWI、DCEMRI、DWI与DCE-MRI联合应用在诊断肝脏 局灶性结节性病变的差异。结果 不同肝 脏局灶性结节性病变间ADC值存在明显差 异(P＜0.05)，多重比较，肝脏转移瘤 ADC值高于原发性肝癌(P＜0.05)，肝血 管瘤ADC值高于肝脏转移瘤(P＜0.05)； 不同肝脏局灶性结节性病变间PV、MSD、 PEI、MSI存在明显差异(P＜0.05)，三组 间SER比较无明显差异(P＞0.05)，肝脏 转移瘤PV、MSD、PEI、MSI低于原发性肝 癌(P＜0.05)，肝血管瘤PV、MSD、PEI、 MSI高于原发性肝癌及肝脏转移瘤(P ＜0.05)；原发性肝癌、肝脏转移瘤、肝 血管瘤动态增强扫描曲线类型存在明显 差异(P＜0.05)；联合诊断原发性肝癌、 肝脏转移瘤、肝血管瘤符合率(97.06%、 100.00%、100.00%)高于单独DWI或单独 DCE-MRI检查(P＜0.05)。结论 联合应 用DCE-MRI及DWI对肝脏局灶性结节性病 变予以诊断，可有效提高疾病诊断符合 率，且利于明确其良恶性质，为临床制 定有针对性干预方案提供一定参考依 据。

Objective To investigate the diagnostic value of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted imaging (DWI) in focal nodular lesions of the liver. Methods A total of 80 cases of focal nodular lesions of liver in our hospital from September 2016 to December 2017 were selected, including 20 cases of hepatic hemangioma, 26 cases of hepatic metastases and 34 cases of primary liver cancer. All patients accepted DWI and DCE-MRI examination respectively. The ADC values and the types of PV, MSD, PEI, SER, MSI and dynamic contrast-enhanced scan curves in different focal nodular lesions of the liver were analyzed, and the differences in the diagnosis of focal nodular lesions of the liver by DWI alone, DCE-MRI alone, DWI associated with DCE-MRI were compared. Results There were a significant difference in the ADC value among different focal nodular lesions of the liver(P＜0.05). In multiple comparison, the ADC value of liver metastases was higher than that of primary liver cancer(P＜0.05). The ADC value of hepatic hemangioma was higher than that of liver metastases(P＜0.05). There were significant differences in PV, MSD, PEI and MSI among different focal nodular lesions of the liver(P＜0.05). There were no significant differences in SER among the three groups(P＞0.05). In multiple comparison, the PV, MSD, PEI and MSI of liver metastases were lower than those of primary liver cancer(P＜0.05). The PV, MSD, PEI and MSI of hepatic hemangioma were higher than those of primary liver cancer and liver metastases(P＜0.05). There were significant differences in the types of dynamic enhanced scan curves among primary liver cancer, liver metastases and hepatic hemangioma(P＜0.05). The combined diagnosis of primary liver cancer, hepatic metastases, and hepatic hemangioma (97.06%, 100%, 100%) was higher than that of DWI and DCE-MRI alone(P＜0.05). Conclusion The combination of DCE-MRI and DWI helps to improve the diagnostic accuracy of the focal nodular lesions in liver, it is helpful to differentiate benign and malignant lesions, and provides a certain reference for the clinical formulation of targeted treatment.