Gd-EOB-DTPA 增强MRI联合多b值DWI成像诊断早期肝癌  

Early hepatocellular carcinoma diagnosed by Gd-EOB-DTPA enhanced MRI combined with multi b-value DWI image

作　　者：黄杰灵 李亮杰[2] 成官迅[3] HUANG Jieling;LI Liangjie;CHENG Guanxun(Department of Radiology, Fifth Affiliated Hospital of Southern Medical University, Guangzhou 510900, P.R.China;Department of Radiology, First People's Hospital of Kashgar, Kashga 844000, P.R.China;Department of Radiology, Shenzhen Hospital, Peking University, Shenzhen 518036, P.R.China)

机构地区：[1]南方医科大学第五附属医院放射科,广东广州510900 [2]新疆喀什地区第一人民医院放射科,新疆喀什844000 [3]北京大学深圳医院放射科,广东深圳518036

出　　处：《医学影像学杂志》2019年第8期1354-1357,共4页Journal of Medical Imaging

基　　金：广东省援疆科技(特派员)项目(编号:2017B020247004)

摘　　要：目的 探讨Gd-EOB-DTPA增强MRI联合多b值DWI成像诊断早期肝癌的应用价值。方法 选取早期肝癌患者30例和肝脏良性肿瘤患者30例行多b值DWI扫描和Gd-EOB-DTPA增强MRI检查,通过诊断筛查试验,筛选具有最佳信噪比与最佳早期肝癌诊断效能的b值,并分析Gd-EOB-DTPA增强MRI诊断早期肝癌的价值,分析最佳b值ADC值、Gd-EOB-DTPA增强MRI单独和联合诊断早期肝癌的价值。结果 DWI扫描诊断筛查试验结果显示,两组患者的B400,B800,B1200,B1600差异比较无统计学意义(P>0.05)。早期肝癌患者的A400,A800,A1200,A1600均明显低于肝脏良性肿瘤患者,差异比较有统计学意义(P<0.05),其中b=1200时诊断早期肝癌最佳,其敏感度、特异度、准确性分别为83.05%、81.97%、82.50%。ROC曲线显示,Gd-EOB-DTPA增强MRI联合诊断早期肝癌的敏感度、特异度、准确性要明显高于Gd-EOB-DTPA增强MRI和最佳b值DWI单独扫描的敏感度、特异度、准确性,曲线下面积(P<0.05)。结论 Gd-EOB-DTPA增强MRI联合多b值DWI成像对早期肝癌的诊断和鉴别诊断能力更强,值得临床推广应用。Objective To study the value of early hepatocellular carcinoma diagnosed by gd-eob-DTPA enhanced MRI combined with multi b-value DWI image. Methods 30 patients with early hepatocellular carcinoma, 30 patients with liver benign tumor were selected as study subjects. Multiple b-value DWI scanning and Gd-EOB-DTPA enhanced MRI examination were performed. Through diagnostic screening tests, we screened the b value with the optimal signal-to-noise ratio and the optimal diagnostic efficiency of early hepatocellular carcinoma and analyzed the value of Gd-EOB-DTPA enhanced MRI in the diagnosis of early hepatocellular carcinoma. The value of optimal b-value, ADC value and Gd-EOB-DTPA enhanced MRI in the diagnosis of early hepatocellular carcinoma were analyzed. Results The results of DWI scanning diagnostic screening test showed that there was no statistically significant difference between B400, B800, B1200 and B1600 of two groups ( P >0.05). Early HCC patients A400, A800, A1200, A1600 were significantly lower than patients with benign tumor of liver ( P <0.05), when b=1 200, the diagnosis value of early hepatocellular carcinoma (HCC) was the best, and the sensitivity, specific degrees and accuracy were 83.05%, 81.97% and 82.50%. ROC curve showed that the specific degrees, accuracy and area under the curve of diagnosis of early hepatocellular carcinoma (HCC) with combination of Gd-EOB-DTPA and enhanced MRI were significantly higher than that single Gd-EOB-DTPA enhancement MRI or single DWI scan ( P <0.05). Conclusion Gd-EOB-DTPA enhanced MRI combined with multi b-value DWI imaging has a stronger ability to diagnose and identify early hepatocellular carcinoma and is worthy of being widely applied in clinic.

关 键 词：肝癌 磁共振成像 钆塞酸二钠 扩散加权成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]