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

摘要： 根据世界卫生组织标准，甲状腺乳头状癌中将直径≤10 mm的肿瘤称为甲状腺微小乳头状癌（PTMC）。随着超声的普及，PTMC的发病率逐年升高，但其对应的死亡率却变化不大。对于无淋巴结转移或远处转移的低风险PTMC患者而言，手术是否是他们的唯一选择？针对这类患者，考虑到其预后好，手术并发症影响大，国外有学者提出了一种新的非手术治疗方法-积极监测（AS），这在国际上引发了大家的热议。本文通过对大家的争议点进行梳理，希望给临床医生的治疗决策带来更好的参考。

关键词: 磁共振成像, 胆囊癌, 弥散加权成像, 慢性胆囊炎