动脉增强分数定量彩图对肝脏局灶性结节增生与肝细胞癌的鉴别诊断价值

发布时间：2018-02-24 03:23

本文关键词： 肝动脉增强分数定量彩图局灶性结节增生肝细胞癌 CT灌注　出处：《临床放射学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨动脉增强分数(AEF)定量彩图对肝脏局灶性结节增生(FNH)与肝细胞癌(HCC)的鉴别诊断价值。方法回顾性搜集行三期MDCT增强扫描后经病理证实的15例FNH患者和18例HCC患者,利用CT Kinetics血流动力学软件计算获得AEF定量彩图。先由两名医师进行双盲法独立计算,分析两名医师计算AEF值的一致性。然后比较两组患者病灶实质部分和周围正常肝组织AEF值的组内差异,以及两组患者病灶实质部分AEF、AEFL/AEFN值的组间差异,并对AEFL/AEFN的鉴别诊断价值进行ROC曲线分析。结果两名医师计算AEF值的一致性良好(ICC=0.95,95%CI=0.92 to 0.97)。FNH组和HCC组病灶实质部分的AEF值[分别为(69.54±7.31)%、(55.63±4.17)%]均高于周围正常肝组织[分别为(44.16±2.63)%、(42.20±3.71)%],差异具有统计学意义(FNH组内t=13.90,P=0.000;HCC组内t=13.29,P=0.000)。FNH组病灶实质部分的AEF值显著高于HCC组(t=6.86,P=0.000);FNH组的AEFL/AEFN值(1.58±0.16)也高于HCC组(1.33±0.13),差异具有统计学意义(t=4.86,P0.001)。AEFL/AEFN值鉴别FNH和HCC的ROC曲线下面积为0.930,当AEFL/AEFN=1.425时Youden指数最大,对应敏感性和特异性分别为86.7%、88.9%。结论 AEF定量彩图能反映FNH和HCC病灶的血流灌注特点,对两者的鉴别诊断具有重要的参考价值。
[Abstract]:Objective to investigate the value of arterial enhanced fraction (MDCT) quantitative color imaging in the differential diagnosis of hepatic focal nodular hyperplasia (FNH) and hepatocellular carcinoma (HCC). Methods Fifteen patients with FNH and 18 patients with HCC confirmed by pathology were collected retrospectively. The quantitative color map of AEF was calculated by CT Kinetics hemodynamic software. To analyze the consistency between the two physicians in calculating the AEF value, and then to compare the difference between the AEF values of the lesion parenchyma and the surrounding normal liver tissue in the two groups, and the difference of the AEFL / AEFN value of the lesion parenchyma between the two groups. The differential diagnostic value of AEFL/AEFN was analyzed by ROC curve. Results the AEF values of the two physicians were in good agreement. The AEF values of the lesions in the FNH group and HCC group [55.63 卤4.17%] were higher than those in the surrounding normal liver tissue [44.16 卤2.63 卤3.71%, respectively]. The difference was statistically significant in the AEF value of the lesion parenchyma in the tnr 13.90 Pu 0.000 HCC group, which was significantly higher than that in the HCC group (1.58 卤0.16) and in the HCC group (1.33 卤0.13). The difference was statistically significant. The area under the ROC curve of FNH and HCC was 0.930. The Youden index is the largest when AEFL / AEFN = 1.425, The corresponding sensitivity and specificity were 86.7 and 88.9.Conclusion AEF quantitative color maps can reflect the blood perfusion characteristics of FNH and HCC lesions, and have important reference value for differential diagnosis of the two lesions.
【作者单位】：中南大学湘雅三医院放射科;GE医疗中国;
【基金】：中南大学研究生自主探索创新基金资助项目(编号:2014zzts373)
【分类号】：R735.7;R730.44

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