摘要
目的探讨MRI平扫、多期动态增强扫描和扩散加权成像(DWI)在小肝细胞癌(SHCC)与肝脏局灶性结节增生(FNH)中的鉴别诊断价值。资料与方法回顾性分析经病理证实的46例SHCC和21例FNH患者的MRI资料,分析MRI鉴别SHCC与FNH的曲线下面积(AUC)、敏感度和特异度。结果平扫T1WI:12个FNH病灶(54.5%)表现为等信号,43个SHCC病灶(82.7%)表现为低信号;动态增强门静脉期T1WI:15个FNH病灶(68.2%)表现为等信号,32个SHCC病灶(61.5%)表现为低信号,两者在SHCC与FNH的鉴别诊断中差异均有统计学意义(Z=-3.418、-5.517,P<0.05),T2WI和DWI在SHCC与FNH的鉴别诊断中差异均无统计学意义(P>0.05)。ROC曲线分析结果显示,T1WI鉴别诊断SHCC与FNH的AUC为0.701,敏感度和特异度分别为59.1%和82.7%;动态增强门静脉期T1WI鉴别诊断SHCC与FNH的AUC为0.881,敏感度和特异度分别为100.0%和61.5%。结论 3.0T MRI平扫T1WI和多期动态增强扫描在SHCC与FNH的鉴别诊断中有较高价值,DWI和T2WI对鉴别诊断起有益的补充。
Purpose To evaluate MRI plain scan,multiphase contrast enhanced scan and diffusion weighted imaging （DWI） in differential diagnosis of small hepatocellular carcinoma （SHCC） and focal nodular hyperplasia （FNH）.Materials and Methods MRI data of 46 cases of SHCC and 21 cases of FNH confirmed by pathology were retrospectively reviewed.ROC curve analysis was performed to determine the area under curve （AUC）,sensitivity and specificity.Results Twelve lesions （54.5％） of FNH appeared as iso-signal and 43 lesions （82.7％） of SHCC appeared as low-signal on T1WI sequence in plain scan,15 lesions （68.2％） of FNH appeared as iso-signal and 32 lesions （61.5％） appeared as low-signal on portal venous phase T1WI fat-suppressed sequence in multi-phase dynamic enhancement,there was statistical significance in differential diagnosis of SHCC and FNH （Z=-3.418 and-5.517,P＜0.05）.There was no statistical significance （P＞0.05）in T2WI and DWI sequences.ROC curve analysis showed the AUC of T1WI in differentiating SHCC and FNH was 0.701,with the sensitivity and specificity of 59.1％ and 82.7％; the AUC of portal venous phase postcontrast T1WI fat-suppressed sequence was 0.881,with the sensitivity and specificity of 100.0％ and 61.5％.Conclusion 3.0T MRI plain scan T1WI and multi-phase dynamic enhancement are usefiul in the differential diagnosis of SHCC and FNH; DWI and T2WI sequences provide additional information.
出处
《中国医学影像学杂志》
CSCD
北大核心
2014年第7期501-504,共4页
Chinese Journal of Medical Imaging
基金
福建省科技厅社会发展重点项目(2011Y0021)
关键词
癌
肝细胞
肝疾病
结节病
磁共振成像
扩散加权成像
图像增强
诊断
鉴别
Carcinoma, hepatocellular
Liver diseases
Sarcoidosis
Magnetic resonance imaging
Diffusion weighted imaging
Image enhancement
Diagnosis, differential
