真实稳态进动快速成像在脂肪肝诊断中的临床应用

发布时间：2018-04-09 18:34

  本文选题：脂肪肝　切入点：磁共振成像　出处：《放射学实践》2017年06期

【摘要】：目的:探讨真实稳态进动快速成像(true-FISP)序列在脂肪肝诊断中的临床应用价值。方法:回顾性分析528例患者的MRI和CT影像学表现,测量true-FISP序列上肝/腰大肌信号强度比值(S_(L/PM)),并与非增强CT检查肝/脾CT值比值(CT_(L/S))结果对比。结果:528例患者CT检查诊断脂肪肝阳性病例组107例,阴性组421例,两组间肝脏CT值(CT_L)、CT_(L/S)、S_(L/PM)均有显著性差异,脾脏CT值(CT_S)无统计学差异,CT_L、CT_S、CT_(L/S)、S_(L/PM)分别为(38.88±12.66)HU、(60.80±5.66)HU(t=-17.46,P0.001);(53.22±3.85)、(52.49±3.65)(t=1.832,P=0.07);(0.73±0.24),(1.16±0.10)(t=-18.43,P0.001);(0.73±0.24)、(1.56±0.28)(t=-23.02,P0.001)。S_(L/PM)与CT_(L/S)正相关(r=0.43,P0.001)。S_(L/PM)最佳诊断分界点为1.14,ROC曲线下面积(AUC)为0.949(P0.001),Kappa值0.797(P0.001),敏感度为88.8%,特异度为94.3%,误诊率5.7%、漏诊率11.2%、总的符合率93.2%、Youden指数83.1%、比数积130.95、阳性预测值88.8%、阴性预测值94.3%。对轻、中、重度脂肪肝诊断的AUC分别为0.857、0.942、0.983(P0.001),敏感度82.6%、100%、100%,特异度86.5%、80.5%、80.2%。结论:true-FISP序列对脂肪肝的诊断具有重要的临床应用价值,当发现肝脏信号强度减低且接近或低于腰大肌时可作为诊断标准,对中、重度脂肪肝的诊断效果高于轻度脂肪肝。
[Abstract]:Objective: to evaluate the clinical value of true steady-state precession fast imaging (FISP) sequence in the diagnosis of fatty liver.Methods: the MRI and CT imaging findings of 528 patients were retrospectively analyzed. The signal intensity ratio of liver / psoas major muscle on true-FISP sequence was measured and compared with that of non-enhanced CT.Results there were significant differences in CT value of liver CT between the two groups in 107 cases of fatty liver positive cases and 421 cases of negative group. There was a significant difference between the two groups.鑴捐剰CT鍊，

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