Gd-BOPTA增强MRI在原发性肝癌诊断中的应用  

Application of Gd-BOPTA Enhanced MRI in the Diagnosis of Primary Liver Cancer

作　　者：胡琼[1] 母青林 国凤高 黄文光[1] 王兴久 HU Qiong;MU Qinglin;GUO Fenggao(Guangyuan First People's Hospital,Guangyuan,628017)

机构地区：[1]四川省广元市第一人民医院,628017

出　　处：《实用癌症杂志》2020年第11期1868-1870,1874,共4页The Practical Journal of Cancer

基　　金：四川省广元市科技局资助项目(编号:18ZDYF0026)。

摘　　要：目的探讨肝脏特异性对比剂钆贝葡胺(Gd-BOPTA)增强MRI在原发性肝癌诊断中的应用价值。方法选取原发性肝癌患者65例共计78个病灶,分析Gd-BOPTA增强MRI扫描图像。结果Gd-BOPTA增强MRI共检出病灶72个,检出率为92.31%,漏检率为7.69%。低分化病灶T1WI动脉期对比噪声比(CNR)为(22.40±9.81),明显低于高分化和中分化病灶(P<0.05);中分化病灶T1WI动脉期CNR为(59.87±26.66),明显低于高分化病灶(P<0.05);不同病理分化病灶T1WI平扫期、T1WI肝胆期、T2WI平扫期CNR比较,差异无统计学意义(P>0.05)。T1WI动脉期CNR鉴别低分化和中高分化病灶的ROC曲线面积为0.867,95%CI为0.785~0.949,P<0.05,截断值为38.92,灵敏性和特异性分别为78.70%和88.24%。结论Gd-BOPTA增强MRI在原发性肝癌诊断中有较好的应用价值,其中T1WI动脉期CNR对原发性肝癌的分化程度具有较高的诊断效能。Objective To evaluate the value of liver-specific contrast agent gadolinium-betamethylamine(Gd-BOPTA)enhanced MRI in the diagnosis of primary liver cancer.Methods 67 patients with primary liver cancer were selected,78 lesions were examined by Gd-BOPTA enhanced MRI.Results 72 lesions were detected by Gd-BOPTA enhanced MRI,the detection rate was 92.31%,and the missed detection rate was 7.69%;The contrast-to-noise ratio(CNR)of the poorly differentiated lesions at T1WI arterial phase was(22.40±9.81),which were significantly lower than that of the well-differentiated and moderately differentiated lesions(P<0.05);The CNR of moderately differentiated lesions at T1WI arterial phase was(59.87±26.66),which was significantly lower than that of highly differentiated lesions(P<0.05);There were no significant difference in CNR between different pathologically differentiated lesions in T1WI plain scan,T1WI hepatobiliary phase,T2WI plain scan(P>0.05);The ROC curve area of differentiation of poorly differentiated and moderately highly differentiated lesions by T1WI arterial phase CNR was 0.867,95%CI was 0.785-0.949,P<0.05,cut-off was 38.92,sensitivity and specificity were 78.70%and 88.24%,respectively.Conclusion Gd-BOPTA enhanced MRI has a good application value in the diagnosis of primary hepatocellular carcinoma,and has a certain value in pathological grading and differentiation.

关 键 词：钆贝葡胺 增强MRI 原发性肝癌 病理分化 

分 类 号：R735.7[医药卫生—肿瘤]