DCE-MRI检查对肝细胞肝癌伴门静脉癌栓的临床诊断及应用价值  

Clinical diagnosis and application value of DCE-MRI in hepatocellular carcinoma with portal vein cancer thrombus

作　　者：方鹏翔 于庆康 石少聪 Fang Peng-xiang;Yu Qing-kang;Shi Shao-cong(Department of Imaging,The Third People's Hospital of Henan Province,Zhengzhou 450007,China;Department of MedicalImaging,Zhengzhou Hospital of Traditional Chinese Medicine,Zhengzhou 450007,China)

机构地区：[1]河南省直第三人民医院影像科,河南郑州450007 [2]郑州市中医院医学影像科,河南郑州450007

出　　处：《四川生理科学杂志》2024年第6期1346-1348,共3页Sichuan Journal of Physiological Sciences

摘　　要：目的:分析磁共振动态增强(DCE-MRI)对肝细胞肝癌伴门静脉癌栓(PVTT)的诊断价值。方法:收集本院2020年1月至2022年4月收治的72例肝细胞肝癌伴PVTT患者的临床资料,患者均接受DCE-MRI及MSCT检测,观察患者MSCT、DCE-MRI检查影像学表现,统计肝细胞肝癌伴PVTT发生情况,并以临床病理结果为金标准,分析MSCT、DCE-MRI对肝细胞肝癌伴PVTT的诊断效果。结果:72例肝细胞肝癌患者经病理确诊29例伴PVTT(40.28%)。肝细胞肝癌伴或不伴PVTT患者在DWI、ADC及动脉期强化上信号比较无明显差异,但肝细胞肝癌伴PVTT患者ADC值明显低于无PVTT患者(P<0.05)。肝细胞肝癌伴PVTT患者动脉期高密度比例及门静脉期低密度比例均显著高于无PVTT患者(P<0.05)。DCE-MRI检查对肝细胞肝癌伴PVTT的诊断AUC值为0.832(95%CI:0.766~0.899),比MSCT检查的AUC值均显著提高(AUC=0.594,95%CI:0.495~0.693)(P<0.05)。结论:DCE-MRI检测可提高临床诊断肝细胞肝癌伴PVTT的效果。Objective:To evaluate the diagnostic value of dynamic magnetic resonance enhancement(DCE-MRI)in hepatocellular carcinoma(HCC)with portal vein cancer thrombus(PVTT).How:Clinical data of 72 patients with hepatocellular carcinoma with PVTT admitted to our hospital from January 2020 to April 2022 were collected.All patients underwent DCE-MRI and MSCT detection.Imaging findings of MSCT and DCE-MRI were observed,and the occurrence of hepatocellular carcinoma with PVTT was statistically analyzed,with clinicopathological results as the gold standard.To analyze the diagnostic effect of MSCT and DCE-MRI on hepatocellular carcinoma with PVTT.Results:Among 72 hepatocellular carcinoma patients,29(40.28%)were pathologically confirmed with PVTT.There were no significant differences in DWI,ADC and arterial phase enhancement in HCC patients with or without PVTT,but ADC values in HCC patients with PVTT were significantly lower than those without PVTT(P<0.05).The proportion of high density in arterial phase and low density in portal vein phase in hepatocellular carcinoma patients with PVTT were significantly higher than those without PVTT(P<0.05).The AUC value of DCE-MRI for diagnosis of hepatocellular carcinoma with PVTT was 0.832(95%CI:0.766~0.899),which was significantly higher than that of MSCT(AUC=0.594,95%CI:0.495~0.693)(P<0.05).Conclusion:DCE-MRI can improve the clinical diagnosis of hepatocellular carcinoma with PVTT.

关 键 词：肝细胞肝癌 门静脉癌栓 磁共振动态增强 表观弥散系数 扩散加权成像 

分 类 号：R735.7[医药卫生—肿瘤]