【摘要】：目的比較T2WI、DWI及Gd-EOB-DTPA增強(qiáng)掃描單獨(dú)序列對(duì)結(jié)直腸癌肝轉(zhuǎn)移瘤的檢出效能。方法選取31例結(jié)直腸癌肝轉(zhuǎn)移患者,均行MR檢查,包括T2WI/FS、DWI、Gd-EOB-DTPA常規(guī)動(dòng)態(tài)增強(qiáng)(MR-Dyn)和肝細(xì)胞期(MR-Late)掃描。由2名醫(yī)師共同閱片,對(duì)每組影像圖像進(jìn)行單獨(dú)分析。記錄所有檢出病灶所在層面、肝段、與肝臟邊緣的距離及病變大小。以手術(shù)病理、術(shù)中超聲及治療前后影像圖像的綜合評(píng)價(jià)作為金標(biāo)準(zhǔn)。采用配對(duì)McNemar檢驗(yàn)比較各序列對(duì)肝轉(zhuǎn)移瘤的檢出率。結(jié)果 31例患者中,共檢出156個(gè)肝轉(zhuǎn)移瘤,大小0.3~7.3cm,≤0.5cm、0.6~1.0cm、1.1~2.0cm和2.0cm分別為20、52、50和34個(gè)。對(duì)肝轉(zhuǎn)移瘤的總體檢出率,T2WI/FS、DWI、MR-Dyn和MR-Late分別為84.62%(132/156)、87.18%(136/156)、67.31%(105/156)和93.59%(146/156)。MR-Late對(duì)肝轉(zhuǎn)移瘤的總體檢出率明顯高于T2WI/FS(P=0.020)和MR-Dyn(P0.001),與DWI的差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.064)。對(duì)≤0.5cm肝轉(zhuǎn)移瘤,T2WI/FS、DWI、MR-Dyn和MR-Late的檢出率分別為30.00%(6/20)、65.00%、(13/20)25.00%(5/20)和85.00%(17/20),MR-Late檢出率明顯高于T2WI/FS(P=0.013)和MR-Dyn(P0.001),與DWI的差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.219)。對(duì)0.6~1.0cm肝轉(zhuǎn)移瘤,T2WI/FS,DWI和MR-Late檢出率分別為88.46%(46/52)、88.46%(46/52)和86.54%(45/52),均明顯高于MR-Dyn(26/52,50.00%)。而對(duì)于1.0cm的肝轉(zhuǎn)移瘤,所有序列檢出率的差異均無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論 Gd-EOB-DTPA增強(qiáng)掃描對(duì)結(jié)直腸癌肝轉(zhuǎn)移的檢出率高,尤其有助于提高≤0.5cm的肝轉(zhuǎn)移瘤病灶檢出率。
[Abstract]:Objective to compare the effectiveness of T 2 WI and Gd EOB DTPA enhanced sequences in detecting liver metastases from colorectal cancer. Methods 31 patients with liver metastases from colorectal cancer were examined by Mr, including T2WI / FSU Gd-EOB-DTPA (MR-Dyn) and hepatocyte phase (MR-Late). Each group of images was analyzed separately by two physicians. All detected lesions were recorded at the level, segment, distance from the edge of the liver, and size of the lesion. The gold standard was surgery and pathology, intraoperative ultrasound and image evaluation before and after treatment. The detection rate of liver metastasis was compared by paired McNemar test. Results A total of 156 hepatic metastases were detected in 31 patients with a size of 0.3 ~ 7.3 cm, 鈮，

本文編號(hào)：2135940