对比钆塞酸二钠增强MR检查中短反转时间反转恢复序列与化学位移选择序列DWI检出肝细胞癌  

Comparison of DWI with short tau inversion recovery sequence and chemical shift selective sequence in gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid enchanced MR for detecting hepatocellular carcinoma

作　　者：蔡健华 王秀彬[2] 陆健[1] 梁宏伟[1] 张学琴[1] 缪小芬[1] 姜吉峰[1] 丁丁[1] 杜圣[1] 黄爱娜[1] CAI Jianhua;WANG Xiubin;LU Jian;LIANG Hongwei;ZHANG Xueqin;MIAO Xiaofen;JIANG Jifeng;DING Ding;DU Sheng;HUANG Aina(Department of Radiology,Nantong Third People's Hospital Affiliated to Nantong University,Nantong 226006,China;Department of Radiology,Affiliated Hospital of Nantong University,Nantong 226006,China)

机构地区：[1]南通大学附属南通第三医院影像科,江苏南通226006 [2]南通大学附属医院影像科,江苏南通226006

出　　处：《中国医学影像技术》2019年第11期1737-1742,共6页Chinese Journal of Medical Imaging Technology

摘　　要：目的对比短反转时间反转恢复(STIR)与化学位移选择(CHESS)序列DWI在钆塞酸二钠(Gd-EOB-DTPA)增强MR检查中对肝细胞癌(HCC)的检出价值。方法回顾性分析37例经病理证实的HCC患者的资料,所有患者均接受上腹部Gd-EOB-DTPA增强MR检查,并于对比剂注射后13~15 min采集STIR及CHESS序列DWI图像。分别测量肝实质的信号强度(SI)、标准差(SD)、ADC值及HCC病灶的SI、ADC值,计算肝实质的SNR及HCC病灶的CNR;并对2种序列图像中HCC病灶的显示程度及肝脏解剖结构的清晰程度进行评分。进行统计学分析,比较STIR与CHESS-DWI序列间SNR、CNR、ADC值的差异及HCC病灶显示程度评分及肝脏解剖结构显示清晰程度评分的差异,并分析不同医师间评分的一致性。结果与CHESS序列比较,STIR序列HCC病灶CNR明显增高(P=0.034),肝实质SNR、ADC值及HCC病灶ADC值明显减低(P均<0.05)。2名医师间HCC病灶显示程度评分及肝脏解剖结构清晰程度评分的一致性均较好(Kappa均≥0.75)。医师1及医师2对HCC病灶显示程度评分及肝脏解剖结构清晰程度的评分结果均显示,STIR与CHESS序列间差异有统计学意义(P均<0.001)。STIR序列HCC病灶显示程度评分多为4分、肝脏解剖结构清晰程度评分多为1分,STIR序列HCC病灶显示程度评分及肝脏解剖结构清晰程度评分均以3分为主。结论 Gd-EOB-DTPA增强MR检查中,STIR序列DWI较CHESS序列更有利于HCC的检出。Objective To compare the detectability of hepatocellular carcinoma(HCC) based on DWI during gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid(Gd-EOB-DTPA) enhanced MR scanning between short tau inversion recover(STIR) and chemical shift selective(CHESS) sequences. Methods Thirty-seven patients with pathologically confirmed HCC were selected for retrospective analysis. All patients underwent Gd-EOB-DTPA enhanced MR scanning of the upper abdomen. Images of DWIs with STIR and CHESS sequences were acquired at 13-15 minutes after Gd-EOB-DTPA injection. The signal intensity(SI), standard deviation(SD), ADC of liver parenchyma and SI、ADC of HCC on DWI with STIR and CHESS sequences were measured. And the SNR of liver parenchyma and CNR of HCC were calculated. The visual grade of conspicuity of HCC and the clarity of hepatic anatomical structure were scored on both two sequences. Statistical analysis was performed. SNR of liver parenchyma, CNR of HCC, ADC of liver parenchyma and HCC, as well as visual score of HCC conspicuity, clarity of hepatic anatomical structure were compared between DWI with STIR and CHESS sequences. The consistency of observation scores between two physicians were also analyzed. Results CNR of HCC of STIR sequence was significantly higher than that of CHESS sequence(P=0.034). SNR of liver parenchyma, as well as ADC of liver parenchyma and HCC of STIR sequence were significantly lower than those of CHESS sequence(all P<0.05). The consistency of visual scores of HCC conspicuity and clarity of hepatic anatomical structure between the two physicians were good(both Kappa≥0.75). Visual scores of physician-1 and physician-2 of HCC conspicuity and the clarity of hepatic anatomical structure were significantly different between STIR and CHESS sequences(all P<0.001). Most of the visual scores of HCC conspicuity of STIR sequence were scored as 4, and most of the clarity of hepatic anatomical structure scores were as 1. The visual scores of HCC conspicuity and clarity of hepatic anatomical structur

关 键 词：癌 肝细胞 对比剂 钆塞酸二钠 扩散磁共振成像 

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