钆塞酸二钠增强MR与增强CT在肝脏局灶性病变诊断中的对比研究  

Comparative study between Gd-EOB-DTPA enhanced MRI and triple phase multidetector CT in diagnosis of focal liver lesions

作　　者：佟晶[1] 卑贵光[1] 李玉泽[1] 徐冉 刘宁 程志亮 

机构地区：[1]中国人民解放军第202医院放射科,辽宁沈阳110003

出　　处：《中国临床医学影像杂志》2017年第9期642-646,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:比较有肝胆期钆塞酸二钠增强MR、无肝胆期钆塞酸二钠增强MR及增强CT对肝脏局灶性病变的诊断效能。方法:38例患者(55个局灶性肝脏病变)行增强CT及钆塞酸二钠增强MR检查,所有肝脏病变均经病理或随访证实。4名放射科医生以六分制评分标准进行独立盲法分析。结果:与增强CT及无肝胆期钆塞酸二钠增强MR相比,有肝胆期钆塞酸二钠增强MR上阅片者将更多的肝脏病变准确归类于良性病变及恶性病变。增强CT诊断肝脏病变的敏感度为51.6%,特异度为56.5%,准确度为53.6%;无肝胆期钆塞酸二钠增强MR诊断肝脏病变的敏感度为68.8%,特异度为59.8%,准确度为65.0%;有肝胆期钆塞酸二钠增强MR诊断肝脏病变的敏感度为89.1%,特异度为78.3%,准确度为84.5%,高于增强CT及无肝胆期钆塞酸二钠增强MR,差异具有统计学意义(P<0.05)。结论:与增强CT及无肝胆期钆塞酸二钠增强MR相比,有肝胆期钆塞酸二钠增强MR可提高阅片者对肝脏局灶性病变的诊断效能。Objective： To compare the value of Gd-EOB-DTPA enhanced MRI with hepatospecific phase with that of Gd-EOB-DTPA enhanced MRI without hepatospecific phase and contrast-enhanced MDCT in diagnosis of focal liver lesions（FLL）. Methods： Thirty-eight patients with 55 FLLs underwent MDCT and Gd-EOB-DTPA enhanced MRI. FLLs were verified based on pathological or follow-up results. CT and MR images were independently analyzed by four radiologists on an ordinal 6-point-scale. Results： Compared to MDCT and MRI without hepatospecific phase, more FLLs were correctly classified into benign and malignant entities by each of the four radiologists on MRI with hepatospecific phase. MDCT achieved sensitivity of 51.6%, specificity of 56.5%, and diagnostic accuracy of 53.6%; MRI without hepatospecific phase achieved sensitivity of 68.8%, specificity of 59.8%, and diagnostic accuracy of 65.0%; MRI with hepatospecific pahse achieved higher sensitivity （89.1%）, specificity（78.3%） and accuracy（84.5%） compared to MDCT and MRI without hepatospecific phase（P〈0.05）. Conclusion： Gd-EOB-DTPA enhanced MRI with hepatospecific phase provides significantly higher diagnostic efficacy compared to MDCT and Gd-EOB-DTPA enhanced MRI without hepatospecific phase in diagnosis of FLLs.

关 键 词：肝肿瘤 肝疾病 体层摄影术 螺旋计算机 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R657.3[医药卫生—临床医学]