摘要
目的:探讨肝胆期钆塞酸二钠(Gd-EOB-DTPA)磁共振(MRI)动态增强扫描在肝硬化结节与小肝癌的鉴别诊断中的应用价值。方法:选取2017年9月至2018年12月收治的肝硬化或疑似小肝癌患者51例,均行肝胆期Gd-EOB-DTPA MRI动态增强扫描。对比小肝癌、肝硬化结节肝胆特异期、DWI图像信号强度;Gd-EOB-DTPA增强动态三期、四期(含肝胆期)图像的诊断信心评分;小肝癌、肝硬化结节在b=400 s/mm2、b=1000 s/mm2DWI序列的表观扩散系数(ADC);Gd-EOB-DTPA增强动态三期、四期(含肝胆期)对小肝癌诊断准确率。结果:小肝癌、肝硬化结节肝胆特异期、DWI图像信号强度具有明显差异(P<0.05);Gd-EOB-DTPA增强动态三期、四期(含肝胆期)图像的诊断信心评分对比,具有明显差异(P<0.05);小肝癌、肝硬化结节在b=400 s/mm2、b=1000 s/mm2DWI序列的ADC值对比,具有明显差异(P<0.05);Gd-EOB-DTPA增强动态三期、四期(含肝胆期)对小肝癌诊断准确率对比,具有明显差异(P<0.05)。结论:肝胆期Gd-EOB-DTPA MRI动态增强扫描利于肝硬化结节、小肝癌的鉴别,且可提高医师对小肝癌诊断准确率、信心。
Objective:To investigate the clinical use of gadolinium-ethoxibenzyl-diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-based dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in hepatobiliary phase in differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma.Methods:Fifty-one patients with cirrhosis or suspected small hepatocellular carcinoma admitted to our hospital between September 2017 and December 2018 were included in the study,and all patients underwent Gd-EOB-DTPA-based DCE-MRI in hepatobiliary phase.The signal intensity of small hepatocellular carcinoma and cirrhosis nodules in hepatobiliary specific phase and DWI images was compared.The diagnostic confidence scores of Gd-EOB-DTPAbased DCE-MRI phaseⅢand IV(including hepatobiliary phase)images were compared.Apparent diffusion coefficient(ADC)of small hepatocellular carcinoma and cirrhosis nodules in b=400 s/mm2 and b=1000 s/mm2 DWI sequences was compared.The diagnostic accuracy of Gd-EOB-DTPA-based DCE-MRI phaseⅢandⅣ(including hepatobiliary phase)for small hepatocellular carcinoma was compared.Results:There was significant difference in the signal intensity of small hepatocellular carcinoma and cirrhosis nodules in hepatobiliary specific phase and DWI images(P<0.05).There were significant differences in the diagnostic confidence scores of GdEOB-DTPA-based DCE-MRI phaseⅢandⅣ(including hepatobiliary phase)images(P<0.05).There was significant difference in ADC of small hepatocellular carcinoma and cirrhosis nodules in b=400 s/mm2 and b=1000 s/mm2 DWI sequences(P<0.05).There was significant difference in the diagnostic accuracy of Gd-EOBDTPA-based DCE-MRI phaseⅢand phaseⅣ(including hepatobiliary phase)for small hepatocellular carcinoma(P<0.05).Conclusion:Gd-EOB-DTPA-based DCE-MRI in hepatobiliary phase favors the differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma,which may improve the accuracy and confidence of physicians in the diagnosis of small hepatocellular carcinoma.
作者
沈丽荣
张立云
戴灼南
Shen Lirong;Zhang Liyun;Dai Zhuonan(Department of Radiology,Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Foshan,Guangdong 528200,China;Department of Radiology,Luocun Hospital of Nanhai District,Foshan,Guangdong 528200,China)
出处
《广州医科大学学报》
2019年第2期44-47,共4页
Academic Journal of Guangzhou Medical University
关键词
肝胆期钆塞酸二钠磁共振动态增强扫描
肝硬化结节
小肝癌
Gadolinium-ethoxibenzyl-diethylenetriamine pentaacetic acid-based dynamic contrast-enhanced magnetic resonance imaging in hepatobiliary phase
cirrhosis nodules
small hepatocellular carcinoma
