增强MR变异系数对乙肝相关早期肝癌的诊断价值  

Value of enhanced MR variation coefficient in the diagnosis of hepatitis b-related early liver cancer

作　　者：王保茎 秦全波 毛怡盛 孔玲 丁丹卉 张国富 WANG Bao-jing;QIN Quan-bo;MAO Yi-sheng;KONG Ling;DING Dan-hui;ZHANG Guo-fu(Department of Magnetic Resonance Room of Medical Imaging,Xuchang Central Hospital,Xuchang 461000,China)

机构地区：[1]许昌市中心医院医学影像科磁共振室,河南许昌461000

出　　处：《中国现代普通外科进展》2019年第11期850-853,共4页Chinese Journal of Current Advances in General Surgery

基　　金：许昌市科技攻关自筹计划项目(20190023)。

摘　　要：目的:探究增强MR变异系数对乙肝相关肝硬化(LC)患者早期肝细胞癌(HCC)的诊断价值。方法:选取许昌市中心医院2017年1月—2018年12月诊断及治疗的乙肝相关LC患者102例及乙肝HCC患者94例,分别纳入LC组及HCC组,两组均行普美显增强MRI检查并计算MR变异系数,同时对比两组血清肿瘤标志物水平,应用ROC曲线评估不同指标对早期HCC的诊断效能。结果:HCC组LgAFP及LgCA199水平显著高于LC组(t=4.562、2.297,P<0.05),HCC组MR变异系数显著高于LC组(6.89±1.33比4.79±1.05;t=9.831,P<0.05),MR变异系数诊断早期HCC的最佳截点为5.14,此时AUC为0.900,显著优于LgAFP及LgCA19-9(Z=3.035、3.880,P<0.05),MR变异系数诊断敏感度为97.87%,显著优于LgAFP(74.47%)及LgCA19-9(48.94%,P<0.05)。结论:增强MR变异系数对于乙肝相关LC患者早期HCC具有较好的诊断效能,显著优于血清学指标。Objective:To explore the diagnostic value of MR variation coefficient enhanced by Gd-EOB-DTPA in early hepatocellular carcinoma(HCC)in patients with liver cirrhosis(LC)associated with hepatitis b.Methods:From January 2017 to December 2018,102 cases of hepatitis b LC patients and 94 cases of hepatitis b HCC patients diagnosed and treated in Xuchang Central Hospital were selected and included in LC group and HCC group respectively,both groups underwent enhanced MRI with Gd-EOB-DTPA and MR variation coefficient was calculated,serum tumor markers of the two groups were compared,and the diagnostic efficacy of different indicators for early HCC was evaluated by ROC curve.Results:The levels of LgAFP and LgCA199 in HCC group were significantly higher than LC group(t=4.562,2.297,P<0.05),MR variation coefficient in HCC group were significantly higher than LC group(6.89±1.33 vs 4.79±1.05,t=9.831,P<0.05),The best cut-off point for MR variation coefficient diagnosis of early HCC was 5.14,and the AUC was 0.900,significantly better than LgAFP and LgCA19-9(Z=3.035,3.880,P<0.05),the sensitivity was 97.87%,significantly better than LgAFP(74.47%)and LgCA199(48.94%,P<0.05).Conclusions:MR variation coefficient enhanced by Gd-EOB-DTPA has better diagnostic efficacy for early HCC in patients with hepatitis b related LC,significantly better than serum indexes.

关 键 词：普美显 增强MR 变异系数 肝细胞癌 肝硬化 乙型肝炎 诊断效能 

分 类 号：R657.31[医药卫生—外科学] R735.7[医药卫生—临床医学]