摘要
目的分析增强CT和MRI轮辐征在鉴别诊断肝脏局灶性结节增生(FNH)和其他肝脏局灶性病变中的价值。方法回顾性分析经病理证实的210例肝脏局灶性病变患者的增强CT及MRI图像,其中FNH 37例(40个病灶),其他肝脏局灶性病变173例(219个病灶)。采用χ;检验比较不同检查方式、增强期相FNH轮辐征的检出率,计算并比较轮辐征、供血动脉征诊断FNH的特异性、敏感性、准确性、阳性预测值、阴性预测值及曲线下面积(AUC)。结果增强CT的FNH轮辐征检出率(78.79%,26/33)明显高于增强MRI(34.38%,11/32)(P<0.001),动脉早期的FNH轮辐征检出率(81.82%,27/33)明显高于动脉晚期(33.33%,10/30)(P<0.001)。轮辐征诊断FNH的敏感性、特异性、准确性、阳性预测值及阴性预测值分别为70.00%、94.98%、91.11%、71.79%和94.55%,AUC为0.85;供血动脉征诊断FNH的敏感性、特异性、准确性、阳性预测值及阴性预测值分别为67.50%、58.45%、59.85%、22.88%和90.78%,AUC为0.63。比较轮辐征和供血动脉征对FNH的诊断效能,轮辐征诊断FNH的特异性、准确性、阳性预测值及AUC均明显高于供血动脉征(P<0.001)。结论增强CT和MRI轮辐征是FNH的特异影像学表现之一,有助于鉴别FNH和其他肝脏局灶性病变,建议在增强CT动脉早期的MIP上观察该征象。
Objective To analyze the value of spoke-wheel sign in the differential diagnosis of hepatic focal nodular hyperplasia(FNH)and other focal hepatic lesions.Methods The enhanced CT and MRI of 210 patients with focal hepatic lesions confirmed by pathology were retrospectively analyzed,including 37 cases of FNH(40 lesions)and 173 cases of other focal hepatic lesions(219 lesions).Chi-square test was used to compare the detection rates of FNH spoke-wheel sign in different examination methods and enhancement phases,and the specificity,sensitivity,accuracy,positive predictive value,negative predictive value and area under curve(AUC)of spoke-wheel sign for diagnosis of FNH were calculated and compared.Results The detection rate of spoke-wheel sign in enhanced CT(78.79%,26/33)was significantly higher than that in enhanced MRI(34.38%,11/32)(P<0.001).The detection rate of spoke-wheel sign in early arterial phase(81.82%,27/33)was significantly higher than that in late arterial phase(33.33%,10/30)(P<0.001).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of feeding artery sign for diagnosis of FNH were 70.00%,94.98%,91.11%,71.79%and 94.55%,respectively,and AUC was 0.85.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of spoke-wheel sign for diagnosis of FNH were 67.50%,58.45%,59.85%,22.88%and 90.78%,respectively,and AUC was 0.63.The specificity,accuracy,positive predictive value and AUC of spoke-wheel sign in the diagnosis of FNH were significantly higher than those of feeding artery sign(P<0.001).Conclusion Enhanced CT and MRI spoke-wheel sign is one of the specific imaging features of FNH,which can help to distinguish FNH from other focal hepatic lesions.It is recommended to observe the spoke-wheel sign in MIP of early arterial phase of enhanced CT.
作者
朱红丽
黄益龙
罗保发
杨铠文
范广涛
马寄耀
陆佳航
何波
ZHU Hongli;HUANG Yilong;LUO Baofa(Department of Medical Imaging,The First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650032,P.R.China)
出处
《临床放射学杂志》
北大核心
2022年第3期484-488,共5页
Journal of Clinical Radiology
关键词
局灶性结节增生
肝脏
轮辐征
体层摄影术
X线计算机
磁共振成像
Focal nodular hyperplasia
Liver
Spoke-wheel sign
Tomography
X-ray computed
Magnetic resonance imaging
