三期增强CT定量参数联合血清miR-122、miR-224对伴脂肪肝的肝占位病变性质诊断效能研究  

Efficacy of quantitative parameters of three-phase contrast-enhanced computed tomography combined with serum miR-122 and miR-224 in diagnosis of liver space-occupying lesions with fatty liver

作　　者：章艳飞 刘文华 Yan-Fei Zhang;Wen-Hua Liu(Department of Radiology,Chun’an County Hospital of Traditional Chinese Medicine,Hangzhou 311700,Zhejiang Province,China)

机构地区：[1]淳安县中医院放射科,浙江省杭州市311700

出　　处：《世界华人消化杂志》2025年第2期131-139,共9页World Chinese Journal of Digestology

摘　　要：背景三期增强计算机断层扫描(computed tomography,CT)是肝占位病变诊断常用检查方法,微小RNA是能调控细胞增殖、凋亡的重要生物标志物.伴脂肪肝的肝占位病变病情复杂,因此探究三期增强CT定量参数与血清微小RNA-122、微小RNA-224联合应用对伴脂肪肝的肝占位病变的诊断价值.目的探究CT增强扫描联合血清miRNA-122(miR-122)、miRNA-224(miR-224)对伴脂肪肝的肝占位病变性质诊断效能,为临床诊疗提供参考.方法前瞻性选取2021-06/2024-06淳安县中医院收治的80例伴脂肪肝的肝占位病变患者为研究对象,经手术或肝穿刺活检病理结果作为“金标准”,确诊伴脂肪肝的肝占位病变良恶性.病理检查前均行CT增强扫描,并测定血清miR-122、miR-224水平.比较不同性质伴脂肪肝的肝占位病变的三期增强CT值、增强指数及血清miR-122、miR-224水平,分析三期增强CT联合血清miR-122、miR-224诊断伴脂肪肝的肝占位恶性病变的效能.结果80例伴脂肪肝的肝占位病变患者中良性病变46例,恶性病变34例.恶性病变CT增强扫描有包膜、强化方式快进快出占比均高于良性病变,密度均匀、有中央瘢痕占比均低于良性病变(P<0.05);恶性病变动脉期、门静脉期、延迟期的CT值、增强指数均低于良性病变(P<0.05);伴脂肪肝的恶性病变血清miR-122水平低于良性病变,miR-224水平高于良性病变(P<0.05);绘制增强CT定量参数、血清miR-122、miR-224联合诊断伴脂肪肝的肝占位恶性病变的受试者工作特征曲线,结果显示增强CT定量参数、miR-122、miR-224联合的曲线下面积最大,为0.946(95%CI:0.972-0.984)(P<0.05).结论伴脂肪肝的良性、恶性肝占位病变患者增强CT定量参数存在显著差异,增强CT参数联合血清miR-122、miR-224对于伴脂肪肝的肝占位恶性病变有较高诊断效能.BACKGROUND Three-phase contrast-enhanced computed tomography(CT)is a commonly used diagnostic method for liver space-occupying lesions,and microRNA is an important biomarker that can regulate cell proliferation and apoptosis.The condition of liver space-occupying lesions with fatty liver is complex,so we explored the diagnostic value of combining quantitative parameters of three-phase contrast-enhanced CT with serum microRNA-122 and microRNA-224 for liver space-occupying lesions with fatty liver.AIM To explore the efficacy of contrast-enhanced CT scanning combined with serum miRNA-122(miR-122)and miRNA-224(miR-224)in the diagnosis of liver space-occupying lesions with fatty liver,to provide a reference for their clinical diagnosis and treatment.METHODS A prospective study was conducted on 80 patients with liver space-occupying lesions accompanied by fatty liver who were admitted to the Chun’an County Traditional Chinese Medicine Hospital from June 2021 to June 2024.The surgical or liver biopsy pathology results were used as the“gold standard”to determine the benign or malignant nature of the liver space-occupying lesions accompanied by fatty liver.Before pathological examination,all patients underwent contrast-enhanced CT scanning and the levels of serum miR-122 and miR-224 were measured.The CT values,enhancement indexes,and serum levels of miR-122 and miR-224 were compared in patients with different types of liver space-occupying lesions accompanied by fatty liver,and the efficacy of three-phase contrast-enhanced CT combined with serum levels of miR-122 and miR-224 in diagnosing malignant liver space-occupying lesions accompanied by fatty liver was evaluated.RESULTS Among the 80 patients with liver space-occupying lesions accompanied by fatty liver,46 had benign lesions and 34 had malignant lesions.On contrast-enhanced CT,malignant lesions exhibited a higher probability of presence of capsules and fast-in and fast-out pattern compared to benign lesions.Additionally,the probability of uniform density and ce

关 键 词：肝占位病变 脂肪肝 增强CT 增强指数 miRNA-224 

分 类 号：R575.5[医药卫生—消化系统]