慢性肝病背景下钆塞酸二钠肝胆期成像对肝癌的检出与定性

发布时间：2018-03-11 13:38

  本文选题：磁共振成像　切入点：钆塞酸二钠　出处：《中国医学影像技术》2015年04期 　论文类型：期刊论文

【摘要】：目的探讨钆塞酸二钠(Gd-EOB-DTPA)肝胆期成像在慢性肝病背景下对肝癌检出和定性的价值。方法回顾性分析99例慢性肝病患者的Gd-EOB-DTPA增强MRI表现,89例患者经临床诊断或病理诊断有肝癌病灶,10例患者临床诊断未见明确异常,作为阴性对照。所有MR图像数据,由2名高年资医师共同阅片,分析肝胆期图像与DWI对肝癌的检出率;另由3名中低年资医师将其分为有肝胆期组和无肝胆期组,并对两组图像独立盲法阅片,比较两组图像肝癌病灶的检出率、诊断信心分值及ROC曲线。组间结果的比较采用Wilcoxon或McNemar非参数检验。结果 89例肝癌患者共检出130个病灶,其中肝癌病灶111个,良性结节19个,111个肝癌病灶中100个经病理证实,11个临床诊断。肝胆期成像对肝癌的检出率高于DWI[99.10%(110/111)vs 90.99%(101/111),P=0.012];有肝胆期组阅片者平均信心分值明显高于无肝胆期组(P=0.001);对于长径≤1cm的小肝癌,有肝胆期组平均检出率高于无肝胆期组[93.00%(17.67/19)vs 70.16%(13.33/19),P=0.016];有肝胆期组ROC曲线下面积亦高于无肝胆期组[0.949(95%CI:0.815~0.995)vs 0.744(95%CI:0.566~0.877),P=0.0023]。结论慢性肝病背景下应用Gd-EOB-DTPA的肝胆期图像的肝癌检出率优于DWI,尤其对于长径≤1cm的小肝癌,同时能够提高诊断信心。
[Abstract]:Objective to investigate the value of Gd-EOB-DTPA-Gd-EOB-DTPA in the detection and characterization of liver cancer in the background of chronic liver disease. Methods Gd-EOB-DTPA enhanced MRI findings of 99 patients with chronic liver disease were retrospectively analyzed. The clinical diagnosis of 10 patients with hepatocellular carcinoma was not clearly abnormal. As a negative control, all Mr image data were read by two senior medical practitioners to analyze the detection rate of hepatobiliary phase images and DWI, and 3 middle and middle aged doctors divided them into hepatobiliary phase group and non-hepatobiliary phase group, and 3 middle and middle aged doctors divided them into hepatobiliary phase group and non-hepatobiliary phase group. The detection rate, diagnostic confidence score and ROC curve of liver cancer were compared between the two groups. The results were compared by Wilcoxon or McNemar nonparametric test. Results 130 lesions were detected in 89 patients with liver cancer. Among them, 111 liver cancer lesions, The positive rate of hepatobiliary phase imaging in hepatocellular carcinoma was higher than that in DWI [99.10 / 111 vs 90.9910 / 111 / P 0.012]; the mean confidence score in patients with hepatobiliary phase was significantly higher than that in patients without hepatobiliary phase (P 0.001). Small hepatocellular carcinoma with diameter 鈮，

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