菲立磁增强MRI对局灶性肝病的诊断价值:与螺旋CT对比的ROC曲线分析  

Diagnostic value of focal hepatic lesions:comparison of feridexs-enhanced MR imaging with enhanced spiral CT by ROC analysis

作　　者：杨汉丰[1] 周翔平[1] 余建群[1] 宋彬[1] 黄娟[1] 李昌宪[1] 李真林[1] 张刚[1] 张青[1] 陈 杨敏[1] 

机构地区：[1]四川大学华西医院放射科,四川成都610041

出　　处：《医学影像学杂志》2004年第8期671-675,共5页Journal of Medical Imaging

摘　　要：目的 :对比分析菲立磁增强扫描与螺旋CT增强扫描对局灶性肝病的诊断价值。方法 :收集经本院完成螺旋CT增强扫描及菲立磁增强MRI扫描且临床、手术病理证实局灶性肝病 2 6例 5 7个病灶 ,采用分组盲法ROC曲线分析对比评价菲立磁增强MRI与螺旋CT增强扫描对局灶性肝病的诊断价值。结果 :联合分析平扫 +菲立磁增强MRI对病灶检出最好 ,与其它三组比较有显著性差异。对病灶定性 ,平扫 +菲立磁增强MRI组ROC曲线下面积Az 值最大为 0 92 6 0 ,准确性为 86 .8% ,差异有显著性 ,P <0 .0 5。螺旋CT增强扫描、MRI平扫及单独分析菲立磁MRI等三种方法之间差异无显著性 (P >0 .0 5 )。结论 :菲立磁增强MRI肝成像无论病灶的检出及定性诊断价值均高于螺旋CT增强扫描。联合分析平扫+菲立磁MRI较单独分析SPIO能明显改善病灶的检出能力及定性诊断能力。Objective:We compared radiologist's performance on combined unenhanced and feridexs-enhanced MR imaging with their performance on helical CT enhanced, unenhanced MRI, and feridexs-enhanced MR alone imaging for the detection and characteristics of local hepatic lesions.Methods:MR images and CT scans obtained in 26 patients with 57 local hepatic lesions were analyzed with ROC analysis.The imaging of patient were divided into 4 groups including combined unenhanced and feridexs-enhanced MR imaging group, helical CT enhanced group, unenhanced MRI group, and feridexs-enhanced MR alone group.Results:Combined unenhanced and feridexs-enhanced MR imaging yielded the best performance for lesion detection, there are significant difference as compared with the other methods. In terms of characterization, the combined approach resulted in larger area under the ROC curve (A z=0 9260) and accuracy (86 8%) (P<0.05 ),as compared with the others methods. There are no significant differences among the other three methods.Conclusion:Feridexs-enhanced MR imaging was more accurate than enhanced helical CT scan in not only detection but also characterization of local hepatic lesion. The combined analysis of unenhanced and feridexs-enhanced images was more accurate in the characterization of focal hepatic lesions than was review of feridexs-enhanced images alone.

关 键 词：肝脏 局灶性病变 磁共振成像 ROC曲线 诊断 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学] R445.2[医药卫生—基础医学]