钆塞酸二钠磁共振增强成像对肝硬化结节与小肝癌的鉴别诊断价值  

Clinical value of Gd-EOB-DTPA magnetic resonance imaging in the differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma

作　　者：章莎莎 吴明灿[1] 胡宁[1] 鲁鹏聪 Zhang Shasha;Wu Mingcan;Hu Ning;Lu Pengcong(Department of Radiology,Yuyao People's Hospital,Yuyao,Zhejiang 315400,China)

机构地区：[1]余姚市人民医院放射科,浙江省315400

出　　处：《中国基层医药》2020年第18期2188-2191,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省余姚市科技计划项目(2018YPT08)。

摘　　要：目的分析肝细胞特异性对比剂钆塞酸二钠磁共振增强成像鉴别诊断肝硬化结节及小肝癌的价值。方法从2017年1月至2018年6月余姚市人民医院收治的肝硬化患者中选取40例作为研究对象,对这些患者进行磁共振平扫、动态增强扫描以及肝胆特异期扫描,对其磁共振图像进行分析。所有的患者在经过磁共振检查之后,给予手术或者穿刺活检术检测其病理结果。根据肝胆特异期病灶的信号强度分为三组:低信号、混杂信号和等信号,并与术后标本的病理分级进行对比、分析。结果40例肝硬化患者在给予磁共振平扫、动态增强扫描后,发现有136个结节被诊断为肝硬化再生结节或增生结节,34例被诊断为小肝癌,在联合钆塞酸二钠肝胆特异期扫描后发现42个小肝癌,差异有统计学意义(χ2=8.962,P<0.05)。42例肝细胞癌肝胆特异期的信号强度与病理分级间差异有统计学意义(P<0.05)。肿瘤的大小与病理分级差异无统计学意义(P>0.05)。结论对怀疑肝细胞癌患者影像检查中选择应用钆塞酸二钠行磁共振增强检查,可以及早的发现有恶变倾向的肝硬化结节及小肝癌,提高临床诊断的准确率。Objective To evaluate and analyze the clinical value of Gd-EOB-DTPA magnetic resonance imaging in the differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma.Methods A total of 40 patients with cirrhosis admitted to Yuyao People's Hospital from January 2017 to June 2018 were enrolled in this study.MRI scan,Gd-EOB-DTPA dynamic enhanced scan and hepatobiliary specific scan were performed in these patients,and their magnetic resonance images were analyzed.All patients underwent magnetic resonance examination and were given surgery or needle biopsy to detect their pathological results.According to the signal intensity of hepatobiliary specific lesions,the patients were divided into three groups:low signal,mixed signal and other signals,and the results were compared with pathological grades of postoperative specimens.Results After 40 patients with cirrhosis received MRI and dynamic contrast-enhanced scans,136 nodules were diagnosed as cirrhotic regenerative nodules or hyperplastic nodules.Thirty-four patients were diagnosed with small hepatocellular carcinoma,and 42 small liver cancers were found after combined with Gb-EOB-DTPA hepatobiliary specific scan,the difference was statistically significant(χ2=8.962,P<0.05).There was statistically significant difference between the signal intensity and pathological grade of 42 cases with hepatocellular carcinoma.There were no statistically significant differences in tumor size and pathological grade.Conclusion For patients with clinically suspected hepatocellular carcinoma,Gd-EOB-DTPA magnetic resonance imaging is helpful to early detection of cirrhotic nodules and small liver cancer with malignant tendency,and can improve the accuracy of clinical diagnosis of diseases.

关 键 词：肝硬化 肝肿瘤 磁共振成像 图像增强 诊断 鉴别 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学] R735.7[医药卫生—临床医学]