Abstract: Objective To evaluate the value of diffusion-weighted imaging （DWI） in the differential diagnosis of benign and malignant gallbladder lesions. Methods A retrospective analysis of 82 cases of postoperative pathologically diagnosed gallbladder lesions， including 58 cases of gallbladder malignant tumors and 24 benign lesions. The difference between ADC values of benign and malignant gallbladder lesions was analyzed by independent t test， and the diagnostic efficacy of ADC value was evaluated by ROC curve. Results The ADC value of gallbladder carcinoma and benign gallbladder lesions was 1.13±0.32×10-3 mm2/s and 1.58±0.33×10-3 mm2/s， respectively. The ADC value of gallbladder carcinoma was significantly lower than that of benign lesions. The area under the ROC curve for the diagnosis of benign and malignant gallbladder lesions was 0.834. When the ADC value was ≤1.38×10-3 mm2/s， the sensitivity of diagnosis of gallbladder cancer was 81.8%， the specificity was 74.1%， and the accuracy was 91.3%. Conclusion DWI has a good application value in the differential diagnosis of benign and malignant gallbladder lesions.

Key words: chronic cholecystitis, magnetic resonance imaging, diffusion-weighted imaging, gallbladder cancer

摘要： 目的 探讨磁共振弥散加权成像（DWI）在胆囊良、恶性病变鉴别诊断中的价值。方法 回顾性分析82例手术后病理确诊胆囊病变病例，其中胆囊恶性肿瘤58例，良性病变24例；采用独立t检验分析比较胆囊良恶性病变ADC值之间的差异，并运用ROC曲线评价ADC值的诊断效能。结果 胆囊癌的ADC值为1.13±0.32×10-3 mm2/s，胆囊良性病变的ADC值为1.58±0.33×10-3 mm2/s，胆囊癌的ADC值明显低于良性病变。ADC值诊断胆囊良恶性病变的ROC曲线下面积为0.834，以ADC值≤1.38×10-3 mm2/s为阈值时，诊断胆囊癌的敏感度为81.8%，特异度为74.1%，准确度为91.3%。结论 DWI在胆囊良、恶性病变鉴别诊断中具有良好的应用价值。

关键词: 胆囊癌, 慢性胆囊炎, 磁共振成像, 弥散加权成像