1.5T磁共振增强扫描和弥散加权成像诊断复发微小肝癌的价值  

The value of contrast-enhanced 1.5T MR and DWI in diagnosing recurrent micro-hepatocelluIar carcinoma

作　　者：阳宁静[1] 黄子星[2] 宋彬[2] 

机构地区：[1]四川省肿瘤医院影像科,四川成都610041 [2]四川大学华西医院放射科,四川成都610041

出　　处：《西部医学》2015年第4期545-549,共5页Medical Journal of West China

基　　金：国家自然科学基金面上项目(81171338)

摘　　要：目的分析1.5T MRI在动态增强扫描(DCE)、弥散加权成像(DWI)及其联合应用(DCE+DWI)在肝癌治疗后检出复发微小癌灶的诊断价值。方法分析肝癌治疗后36例45个复发微小病灶的DWI及DCE扫描序列,与最终复发诊断结果对照,计算不同方法诊断复发微小肝癌(MHCC)的敏感度、特异度及Kappa值。结果 DCE在复发MHCC诊断中敏感度83.3%、特异度90.9%、准确性为88.9%,与最终诊断的Kappa值为0.857;DWI对复发MHCC判断的敏感度为60.0%、特异度为76.0%、准确性为62.2%,Kappa值为0.786;DCE+DWI对复发MHCC诊断敏感度为87.5%、特异度为96.6%、准确度为93.3%,Kappa值为0.965。结论 1.5TMR检查(联合DWI+DCE)在诊断复发MHCC方面具有较高的诊断敏感性及特异性,优于单独DWI或DCE序列。Objective To analyze usefulness of 1. 5T dynamic contrast enhanced magnetic resonance imaging （DCE MRI） and diffused weighted imaging（DWl） in diagnosis of recurrent micro-hepatocellular carcinoma after treat ment. Methods A total of 36 cases with 45 lesions of Micro hepatocellular carcinoma （MHCC） after treatment were detected and analyzed, sensitivity, specificity and accuracy value of different methods for diagnosis of MHCC were calculated. The Kappa value was also counted using the final recurrent diagnosis as the reference standard. Results The sensitivity, specificity, accuracy and the Kappa value of the DCE in detecting the recurrent MHCC were 83.3%, 90.9%, 88.9%, 0.857 respectively; The sensitivity, specificity, accuracy and the Kappa value of the DWI in evaluating the recurrent MHCC were 60.0%, 76.0%, 62.2% and 0. 786 respectively. While the sensitivity, specificity, accuracy and the Kappa value of the combination of DWI and DCE in diagnosing the recurrent MHCC were 87.5%, 96.6%, 93.30% and 0. 965 respectively. Conclusion The combination of DCE and DWI of 1.5T MR imaging is more useful for evaluation of diagnosis about recurrent MHCC because of its higher sensitivity, specificity, accuracy.

关 键 词：肝细胞性肝癌 磁共振弥散成像 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]