Gd-EOB-DTPA增强MRI诊断肝脏非典型局灶结节增生的临床价值  

Clinical value Gd-EOB-DTPA MRI in diagnosing atypical focal nodular hyperplasia

作　　者：李晓明[1] 王玉婷[1] 赵骏[1] 石彦殊 刘晓玲[1] 张琳[1] 

机构地区：[1]第三军医大学西南医院放射科,重庆400038

出　　处：《放射学实践》2015年第12期1212-1216,共5页Radiologic Practice

摘　　要：目的:通过与超声造影比较,探讨钆塞酸二钠动态增强MRI对非典型局灶性结节增生(FNH)的诊断价值。方法:32例经病理检查或随访证实的局灶性结节增生(共41个病灶)患者2012年1月-2015年5月在我院同时行超声造影和钆塞酸二钠动态增强3.0T MRI检查,回顾性分析FNH的影像学表现,对比分析两种检查方法对不典型FNH的诊断敏感性、特异性及准确性。结果:32例中超声造影共发现34个病灶,正确诊断FNH病灶29个,误诊2个,漏诊14个,其诊断敏感度、特异度和符合率分别为65.9%、60.0%和65.2%;所有病灶均未见中心瘢痕显示。钆塞酸二钠动态增强MRI共发现46个肝内病灶,其中正确诊断39个FNH,漏诊2个,误诊5个,其诊断敏感度、特异度和符合率分别为95.1%、100.0%和84.8%;FNH动态增强扫描表现为持续性强化,在肝胆期多呈等或稍高信号。两种检查方法对FNH的诊断准确性的差异有统计学意义(P<0.03)。结论:钆塞酸二钠动态增强MRI对局灶性结节增生的检出率及诊断信心明显优于超声造影。Objective： To study the value of Gadolinium ethoxybenzyl-diethylenetriamine pentaacetic acid （Gd EOB DTPA）-enhanced MRI in comparison with contrast-enhanced ultrasound （CEUS） for diagnosis of atypical focal nodular hy- perplasia （AFNH）. Methods：From January 2012 to May 2015, CEUS and 3.0T Gd EOB-DTPA-enhanced MRI data of 32 FNH patients proved by pathology or follow-up were retrospectively analyzed. Sensitivity, specificity and accuracy of the two examinations for diagnosing FNHs were compared and evaluated. Results： Of the 32 FNHs patients, 34 hepatic lesions were detected by CEUS,including correct diagnosis in 29 FNHs,misdiagnosis in 2 lesions, missed diagnosis in 14 lesions;no central scar was showed. While on Gd-EOB-DTPA MRI,46 lesions were detected, of which 39 lesions were correctly diag- nosed as FNH with misdiagnosis in 5 lesions and missed-diagnosis in 2 lesions;the main MRI features of FNH were conti- nuous enhancement,hyper- or iso intensity in hepatobiliary phase. The sensitivity, specificity and accuracy of Gd-EOB-DT PA MRI and CEUS were 95. 1 %, 100.0 %, 84. 8 % and 65. 9 %, 60.0 %, 65. 2%, respectively. There was significant diffe- rence between the two examination （P〈0.03）. Conclusion： The detection rate and diagnostic confidence of Gd-EOB-DTPA MRI are superior to CEUS in diagnosis of FNH.

关 键 词：肝肿瘤 局灶性结节增生 对比剂 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R734.31[医药卫生—诊断学]