磁共振动态增强扫描对肝转移瘤的诊断价值研究  

The research for diagnostic value of MRI dynamic enhancement scanning of liver metastasis cancer

作　　者：魏君臣[1] 孙新海[1] 卞婷婷[1] 翟宁[1] 

机构地区：[1]济宁医学院附属医院磁共振室,山东济宁272029

出　　处：《社区医学杂志》2015年第21期13-16,共4页Journal Of Community Medicine

基　　金：山东省高等学校科技计划项目(J13LL05)

摘　　要：目的探讨肝转移瘤的强化特征与信号值的相关性,研究磁共振动态增强扫描成像对肝转移瘤的诊断价值。方法回顾性分析2013年1月—2015年5月肝胆外科、肿瘤科收治的肝转移瘤患者100例作为研究对象,均行MRI平扫加动态增强扫描,比较磁共振单纯平扫和平扫加动态增强扫描对各期癌组织的诊断敏感度、特异度、阳性预测值、阴性预测值及各期癌组织信号值。计数资料采用χ2检验,计量资料采用方差分析,P<0.05为差异有统计学意义。结果 MRI平扫加动态增强扫描诊断Ⅰ期癌组织的敏感度、特异度、阳性预测值分别为62.50%、89.71%、74.07%,均高于磁共振平扫的37.50%、67.65%、35.29%,差异均有统计学意义(均P<0.05)。MRI平扫加动态增强扫描诊断Ⅱ期癌组织的敏感度、特异度、阳性预测值、阴性预测值分别为73.17%、74.58%、66.67%、78.57%,均高于磁共振平扫的31.71%、47.46%、29.55%、50.00%,,差异均有统计学意义(均P<0.05)。MRI平扫加动态增强扫描诊断Ⅲ期癌组织的敏感度为59.26%,高于磁共振平扫的25.93%,差异有统计学意义(P<0.05)。正常肝组织平扫、动脉期、静脉期、延迟期信号值分别为(31.5±0.6)、(53.3±4.2)、(68.6±0.8)、(60.4±1.2),Ⅰ期癌组织分别为(21.7±0.2)、(51.4±3.6)、(64.1±1.2)、(58.4±4.5),Ⅱ期癌组织分别为(21.4±0.4)、(50.2±2.1)、(61.9±2.1)、(54.5±1.5),Ⅲ期癌组织分别为(20.8±0.3)、(48.9±5.1)、(59.9±0.4)、(50.1±5.9);磁共振正常肝组织信号值与各期肝转移癌组织信号值比较差异均有统计学意义(均P<0.05)。各期肝转移癌组织信号值比较差异均有统计学意义(均P<0.05)。结论 MRI平扫加动态增强检查方法能够更加准确且真实的反映肝脏病变组织成分,对肝转移瘤的检出率和诊断准确性均较高,具有良好的诊断价值。Objective To investigate the correlation between enhancement features and the signal value of metastatic liver cancer,the study of magnetic resonance diagnostic value of enhanced dynamic scanning imaging of hepatic metastasis carcinoma.Methods 100 cases of liver metastases from January 2013 to May 2015 were selected, all the patient have MRI plain and dynamic enhancement examination. Compare the tissue diagnostic sensitivity, specific, positive predictive value, negative predictive value and the period signal value of cancer tissue of the MRI plain examination and MRI dynamic enhancement examination.Count data was processed by chi square test, measurement data was processed by ANOVA, P〈0.05 was considered statistically significant. Results The sensitivity, specificity, positive predictive value of MRI plain scan and dynamic enhanced scan in the diagnosis of stage I cancer tissues were 62.50%,89.71%,74.07%,higher than that of ordinary MRI plain examination（37.50%、67.65%、35.29%）,the differences were statistically significant（all P〈0.05）. The sensitivity, specificity, positive predictive value and negative predictive value of MRI plain scan and dynamic enhanced scan in the diagnosis of stage Ⅱ cancer tissues were 73.17%,74.58%,66.67%,78.57%, higher than that of ordinary MRI plain examination（31.71%,47.46%,29.55%,50.00%）, the differences were statistically significant（all P〈0.05）. The sensitivity of MRI plain scan and dynamic enhanced scan in the diagnosis of stageⅢ cancer tissues was 59.26%, higher than that of ordinary MRI plain examination（25.93%）,the difference was statistically significant（P〈0.05）. The signal values of normal liver tissue unenhanced, arterial, venous phase, delayed phase were（31.5±0.6）,（53.3±4.2）,（68.6±0.8）,（60.4±1.2）, in stage Ⅰcarcinoma were（21.7±0.2）,（51.4±3.6）,（64.1±1.2）,（58.4±4.5）, in stage Ⅱ carcinoma were（21.4 ±0.4）,（50.2±2.1）,（61.9±2.1）,（54.5±1.5）, in stage Ⅲ carcinoma were（ 20.8 �

关 键 词：磁共振动态增强扫描 肝转移瘤 诊断价值 

分 类 号：R445.2[医药卫生—影像医学与核医学]