钆贝葡胺磁共振成像对肝细胞癌的诊断价值  

Diagnostic Value of Gd-BOPTA One-stop Dual Function Contrast Enhanced MRI in Hepatocellular Carcinoma

作　　者：李丽艳[1] 褚丽娟 王宏光[2] 郭云志[1] 郭微 周顺科[3] LI Li-yan CHU Li-juaR WANG Hong-guang GUO Yun-zhi GUO Wei ZHOU Shun-ke(Department of Radiology, Jilin City People＇s Hospital Department of Gastroenterology, Jilin City People＇s Hospital Department of Radiology, Xiangya Second Hospital, Central Southern University)

机构地区：[1]吉林市人民医院放射科 [2]吉林市人民医院消化内科 [3]中南大学湘雅二医院放射科

出　　处：《中国医学计算机成像杂志》2017年第5期433-437,共5页Chinese Computed Medical Imaging

基　　金：吉林省卫生厅科研项目;No.2013Z064~~

摘　　要：目的:探讨钆贝葡胺(Gd-BOPTA)一站式双功能对比MR成像(DFCE-MRI)对于肝细胞癌(HCC)诊断的价值。方法:对117例肝脏局灶性病变(FLL)患者行Gd-BOPTA一站式DFCE-MRI,包括:(1)MR平扫;(2)弥散加权成像(DWI);(3)Gd-BOPTA多期增强;(4)肝胆期扫描,比较Ⅰ((1))、Ⅱ((1)+(3))、Ⅲ((1)+(2)+(3))、Ⅳ((1)+(2)+(3)+(4),即:一站式DFCE-MRI)等四种扫描方案对于FLL的检出率和对HCC诊断的敏感性、特异性、准确性。结果:Ⅰ~Ⅳ四种扫描方案对FLL检出率分别为74.2%、87.4%、98.7%和98.7%,四者差异有统计学意义(P<0.05),方案Ⅰ检出率明显低于其他三种增强扫描方案;Ⅱ~Ⅳ三种增强扫描方案对HCC诊断的敏感度、特异度、准确度分别为76.2%、70.1%和73.1%,92.9%、82.9%和85.5%,92.9%、90.5%和91.2%,三者差异有统计学意义(P<0.05),且以方案Ⅳ准确度最高。结论:Gd-BOPTA一站式DFCE-MRI对FLL检出率以及对HCC诊断的准确度优于其他扫描方案,可以作为肝细胞癌鉴别诊断的优选MR扫描方案。Purpose： To investigate the value of gadobenate dimeglumine （Gd-BOPTA） one-stop dual functional contrast enhanced （DFCE） MRI for focal liver lesions （FLL） detection and hepatocellular carcinoma （HCC） diagnosis. Methods： One hundred and seventeen cases of FLL patients underwent Gd-BOPTA one-stop DFCE-MRI, including MR plain scan （PS）, diffusion-weighted imaging （DWI）, Gd-BOPTA enhanced multiphase scan （EMS） and hepatobiliary phase scan （HBS）. The capabilities of four scanning schemes was assessed in detecting FLL and diagnosing HCC, and four scanning schemes included scheme I （PS）, scheme II （PS ＋ Gd-BOPTA EMS）, scheme III （PS ＋ DWI ＋ Gd-BOPTA EMS）, and scheme IV （PS ＋ DWI ＋ Gd-BOPTA EMS ＋ HBS, that was： Gd-BOPTA one-stop DFCE-MRI）. Results： The detection rate of four scanning schemes from I to IV for FLL were 74.2%, 87.4%, 98.7% and 98.7%. There was statistical significant difference between the four groups （P〈0.05）, detection rate of PS was significantly lower than the other three contrast enhancement MR （CE-MR） scan schemes. The diagnosis sensitivity, specificity and accuracy of these three CE-MR scanning schemes for HCC from rl to IV were 76.2%, 70.1% and 73.1%, 92.9%, 82.9% and 85.5%, 92.9%, 90.5% and 91.2% respectively. There was significant difference between the three groups （P〈0.05）, and the accuracy of one-stop DFCE-MRI was the highest. Conclusion： The detection rate of Gd-BOPTA one-stop DFCE-MRI for FLL and the diagnostic accuracy for HCC is superior to those of other scanning scheme. Gd-BOPTA one-stop DFCE-MRI can be used as the preferred scanning schemes for the differential diagnosis of hepatocellular carcinoma.

关 键 词：磁共振成像 钆贝葡胺 局灶性病变 肝细胞癌 

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]