磁共振成像对比剂Gd-EOB-DTPA动态增强对肝脏局灶性病变的临床价值  

To compare the role of Gd-EOB-DTPA dynamic contrast-enhanced MRI with multi-detector row computedtomography （MDCT） in patients with focal liver lesions

作　　者：李小庆[1] 周智鹏[2] 何松青[1] 陈孝平[3] 

机构地区：[1]桂林医学院附属医院肝胆外科,广西541001 [2]桂林医学院附属医院放射科,广西541001 [3]华中科技大学同济医学院附属同济医院肝脏外科中心

出　　处：《中华肝胆外科杂志》2013年第11期815-820,共6页Chinese Journal of Hepatobiliary Surgery

基　　金：广西科技厅科技攻关项目（桂科攻1298003-2-1）;广西高等学校重点资助科研项目（201102ZD024）;吴阶平医学基金会肝病医学部肝功能评价方法研究基金（LDWMF-PJ-20118005）;广西壮族自治区卫生厅自筹经费科研课题（Z.2013515）

摘　　要：目的比较钆塞酸二钠（Gd-EO昏DTPA）动态对比增强磁共振成像（DCE-MRI）与多排螺旋CT（MDCT）对肝脏局灶性病变检出的敏感性、特异性及诊断准确度。方法回顾性分析我院影像科32例肝脏局灶性病变患者磁共振、MDCT检查结果。将所有患者分为CT组和MRI组，采用受试者工作特征曲线（ROC）分析每组患者的检查结果。结果共确定病灶185处。MRI组对病灶检出的敏感性、特异性及R0c曲线下面积（AUC分别为86．5%、90．9％、0．855）均明显高于MDCT组（63．6％、54．5％、0．532）。DCE-MRI对〈1cm病灶检出的敏感性、特异性及AUC（90％、86．6％、0．886）亦较MDCT（50．5％、45．5％、0．500）具有明显优势。结合病理及随访结果，联合Gd-EOB-DTPADCE—MRI对病灶的诊断符合率为78．1％（25／32），高于MDCT的诊断符合率56．2％（18／32）。结论联合对比剂Gd-EOB-DTPADCE—MRI较单独使用MDcT对肝脏局灶性病变，尤其是对≤1cm的肝癌及肝转移瘤的检出具有更高的敏感性、特异性及诊断准确度。Objective To compare the role of Gd-EOB-DTPA dynamic contrast-enhanced mag- netic resonance imaging （DCE-MRI） with multi- detector row computed tomography （MDCT）, and to determine the sensitivity, specificity and accuracy in foca! hepatic lesions. Methods A retrospective a- nalysis was conducted on 32 patients with focal hepatic lesions who had undergone MRI and MDCT examinations. These patients were divided into two groups： the CT group and the MRI group. The results were analysed using receiver operating characteristic （ROC） curves. Result There were 185 focal hepatic lesions. The sensitivity, specificity and the area under the ROC curve （AUC） were 86.5%, 90.9%, 0. 855, respectively for the MRI group and they were significantly higher than the CT group （63.6%, 54.5%, 0. 532）. For detection of lesions 〈1 cm, the sensitivity, specificity and the area under the ROC curve （AUC） for the MRI group were 90%, 86.6%, 0. 886, respectively, which were also significantly higher than the CT group （50.5%, 45.5%, 0. 500）. When combined with pathological findings and follow-up, the diagnostic accuracy was 40.6% using Gd-EOB-DTPA DCE- MRI. Conclusion Gd-EOB-DTPA DCE-MRI has a higher detection rate, better accuracy and diagnostic value for focal liver lesions （〈1 cm） than MDCT.

关 键 词：钆塞酸二钠 动态增强磁共振成像 肝脏局灶性病变 

分 类 号：R445.2[医药卫生—影像医学与核医学]