磁共振多参数定量技术用于诊断肝癌结节的价值  

Value of multi-parametric quantitative magnetic resonance imaging in the diagnosis of liver cancer nodules

作　　者：李贞旭[1] 童姗姗[2] 张晓亚[1] 向旭[1] 吕国义[1] 张中南[1] Li Zhenxu;Tong Shanshan;Zhang Xiaoya;Xiang Xu;Lyu Guoyi;Zhang Zhongnan(Department of Magnetic Resonance Imaging,Nanyang Central Hospital,Nanyang 473000,China;School of Mathematics and Physics,Nanyang Institute of Technology,Nanyang 473000,China)

机构地区：[1]南阳市中心医院磁共振影像诊断科,南阳473000 [2]南阳理工学院数理学院,南阳473000

出　　处：《中国实用医刊》2024年第3期79-82,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析磁共振(MRI)多参数定量技术用于诊断肝癌结节的价值。方法观察性研究。抽取2021年4月至2023年6月南阳市中心医院收治的73例肝脏结节患者为研究对象,均行MRI、CT诊断,以病理结果为"金标准",比较MRI、CT对肝癌结节和再生性结节的诊断结果、诊断效能、诊断预测值(阳性预测值、阴性预测值);对比肝癌结节和再生性结节MRI动态增强扫描定量参数[最大下降斜率(MSD)、最大上升斜率(MSI)、获得平均强化时间(MEF)]、MRI定量参数[增强率(ER)、脂肪分数(FF)、表观扩散系数(ADC)]。结果本组73例疑似肝癌结节患者,病理检查确诊肝癌结节44例,再生性结节29例;采用MRI诊断出肝癌结节43例,再生性结节30例;采用CT诊断出肝癌结节42例,再生性结节31例。MRI诊断灵敏度、特异度、准确度(93.18%,41/44;93.10%,27/29;93.15%,68/73)高于CT诊断(77.27%,34/44;72.41%,21/29;75.34%,55/73),漏诊率、误诊率(6.82%,3/44;6.90%,2/29)低于CT诊断(22.73%,10/44;27.59%,8/29),P<0.05。MRI诊断阳性预测值与CT诊断比较差异未见统计学意义(P>0.05);MRI诊断阴性预测值(90.00%,27/30)高于CT诊断(67.74%,21/31),P<0.05。肝癌结节MSD参数高于再生性结节,MSI、MEF参数低于对照组(P<0.05)。肝癌结节ER值、ADC值低于再生性结节,FF值高于再生性结节(P<0.05)。结论肝癌结节和再生性结节患者MRI图像纹理参数、增强扫描参数和定量参数存在明显差异,采用MRI多参数定量技术诊断肝癌结节可提高诊断效果。Objective To analyze the value of multi-parametric quantitative magnetic resonance imaging(MRI)in the diagnosis of liver cancer nodules.Methods A total of 73 patients with liver nodules treated in Nanyang Central Hospital from April 2021 to June 2023 were selected as the research objects of the observational study.And they all underwent MRI and computed tomography(CT)examinations for diagnosis.Taking the pathological results as the gold standard,the diagnostic results,diagnostic efficiency,and diagnostic predictive values(positive predictive value,negative predictive value)of MRI and CT in the diagnosis of liver cancer nodules and regenerative nodules were compared.Parameters of dynamic contrast-enhanced MRI,including maximum slope of decrease(MSD),maximum slope of increase(MSI)and mean enhancement time(MEF),and MRI quantitative parameters,including enhancement rate(ER),fat fraction(FF)and apparent diffusion coefficient(ADC),of liver cancer nodules and regenerative nodules were compared.Results Among the 73 patients with suspected liver cancer nodules,pathological examination identified 44 cases with liver cancer nodules and 29 cases with regenerative nodules.MRI identified 43 cases with liver cancer nodules and 30 cases with regenerative nodules.CT identified 42 cases with liver cancer nodules and 31 cases with regenerative nodules.The sensitivity,specificity,and accuracy of MRI(93.18%,41/44;93.10%,27/29;93.15%,68/73)were higher than those of CT(77.27%,34/44;72.41%,21/29;75.34%,55/73)in the diagnosis;while the missed diagnosis rate and misdiagnosis rate of MRI(6.82%,3/44;6.90%,2/29)were lower than those of CT(22.73%,10/44;27.59%,8/29),P<0.05.There was no statistically significant difference in the positive predictive values between MRI and CT(P>0.05).The negative predictive value of MRI(90.00%,27/30)was higher than that of CT(67.74%,21/31),P<0.05.The MSD of liver cancer nodules was higher than that of regenerative nodules,while the MSI and MEF of liver cancer nodules were lower than those of the regenerative nod

关 键 词：肝癌 再生性结节 磁共振 

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