普美显增强MRI与CT对原发性肝癌诊断的价值研究  

Research on the value of Gd-EOB-DTPA-enhanced MRI and CT in diagnosis of primary liver cancer

作　　者：黄淑芳[1] 李长清[1] 罗是是[1] HUANGShu-fang;LI Chang-qing;LUO Shi-shi(Radiation Department, Hainan General Hospital (Hainan Affiliated Hospital of HainanMedical University), Haikou 570311, China;不详)

机构地区：[1]海南省人民医院(海南医学院附属海南医院)放射科,海南海口570311

出　　处：《中国医学装备》2022年第6期43-48,共6页China Medical Equipment

基　　金：海南省卫生计生行业科研项目(16A200088)“肝脏特异性MRI对比剂增强联合DWI在肝脏局灶性病变诊断”。

摘　　要：目的:探究普美显增强磁共振成像(MRI)与X射线计算机断层扫描(CT)对原发性肝癌(PHC)的诊断价值。方法:选取医院收治的85例拟诊PHC患者,通过普美显增强MRI和CT对原发性肝癌进行诊断,以手术病理结果为“金标准”,分析两种诊断的准确性,采用Kappa检验分析两种诊断的一致性及诊断价值。结果:在85例疑似PHC患者中,经手术病理证实PHC74例(占87.06%),其中肝细胞癌59例,肝内胆管癌12例,混合型肝癌3例;非PHC患者11例(占12.94%)。普美显增强MRI和CT诊断PHC的灵敏度分别为97.30%和87.84%。普美显增强MRI诊断PHC、不同类型和PHC病灶肿瘤直径与手术结果的Kappa值分别为0.791、0.880和0.904,一致性较好;CT诊断PHC、检出PHC肿瘤直径与手术结果的Kappa值分别为0.431、0.529和0.708,一致性一般。普美显增强MRI与CT在检查动脉期、延迟期信号的情况均无明显差异,但在检查门脉期信号情况时差异有统计学意义(x^(2)=22.620,P<0.05)。结论:普美显增强MRI诊断原发性肝癌准确率高,有利于对不同类型PHC的鉴别诊断以及对小直径病灶的检出。Objective: To explore the value of Gd-EOB-DTPA-enhanced magnetic resonance imaging(MRI) and X-ray computed tomography(CT) in the diagnosis of primary liver cancer(PHC). Methods: A total of 85 patients with suspected PHC admitted to the hospital were selected, and diagnosis of primary liver cancer was conducted through Gd-EOB-DTPA-enhanced MRI and CT. Taking the surgical results as the gold standard, the accuracy of the two diagnoses was analyzed, and Kappa was used to analyze the consistency and diagnostic value of the two diagnoses.Results: Among the 85 patients with suspected PHC, 74 patients(87.06%) with PHC were confirmed by surgery,including 59 patients with hepatocellular carcinoma, 12 patients with intrahepatic cholangiocarcinoma, and 3 patients with mixed liver cancer;11 patients of non-PHC(12.94%). The sensitivity of Gd-EOB-DTPA-enhanced MRI and CT in the diagnosis of PHC was 97.30% and 87.84%, respectively. The Kappa values of Gd-EOB-DTPA-enhanced MRI in the diagnosis of PHC, tumor diameters of different types and PHC lesions and the surgical results were 0.791, 0.880and 0.904, respectively, showing good consistency. The Kappa values of CT diagnosis of PHC, detection of PHC tumor diameter and surgical results were 0.431, 0.529 and 0.708, respectively, showing a general consistency. There was no significant difference between the Gd-EOB-DTPA-enhanced MRI and CT in the detection of signals in the arterial phase and the delayed phase, however, the difference was statistically significant in the detection of the signals in the portal venous phase(x^(2)=22.620, P<0.05). Conclusion: The Gd-EOB-DTPA-enhanced MRI has high accuracy in diagnosing primary liver cancer, which is helpful for the diagnosis and identification of different types of PHC and the detection of small-diameter lesions.

关 键 词：原发性肝癌(PHC) 普美显增强磁共振成像(MRI) 计算机体层扫描(CT) 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]