【摘要】：目的探討釓塞酸二鈉(Gd-EOB-DTPA)MR掃描對乙肝肝硬化背景肝癌的診斷價值。方法 32例乙肝肝硬化患者共34個肝癌病灶,均行兩種MR成像[模式1:T2WI、DWI、T1WI同反相位、Gd-DTPA動態(tài)增強(平掃、動脈期、門靜脈期及延遲期);模式2:T2WI、DWI、T1WI同反相位、Gd-EOB-DTPA動態(tài)增強(平掃、動脈期、門靜脈期、延遲期及肝膽期)]。由2名閱片者采用雙盲法分析圖像,記錄病灶的信號特點、強化方式及閱片者的信心評分。比較兩種成像模式下閱片者診斷肝癌信心評分、一致性、ROC曲線下的面積、敏感性及陽性預測值。結果 (1)模式2下兩位閱片者診斷肝癌的信心評分均提高,差異有統(tǒng)計學意義(P0.05);且2名閱片者在模式2下診斷肝癌的一致性均增加。(2)2名閱片者在模式2下診斷肝癌的ROC曲線下面積均較模式1增加,差異有統(tǒng)計學意義(P0.05)。(3)2名閱片者在模式2下診斷肝癌的敏感性較模式1均提高,差異有統(tǒng)計學意義(P0.05),陽性預測值差異均無統(tǒng)計學意義(P0.05)。結論 Gd-EOB-DTPA MR掃描有助于提高閱片者對乙肝肝硬化背景肝癌的診斷信心從而提高診斷能力。
[Abstract]:Objective to evaluate the diagnostic value of gadolinium disodium (Gd-EOB-DTPA) MR scan in background liver cancer of hepatitis B cirrhosis. Methods Thirty-four liver cancer lesions were performed in 32 patients with hepatitis B cirrhosis. Two kinds of MR imaging were performed [1: T2WIWI DWI T1WI, Gd-DTPA dynamic enhancement (plain scan, arterial phase, portal vein phase and delayed phase); In mode 2: T2WI / DWII T1WI, Gd-EOB-DTPA was enhanced dynamically (plain scan, arterial phase, portal vein phase, delayed phase and hepatobiliary phase). The image was analyzed by double blind method, and the signal characteristics, enhancement mode and confidence score of the film reader were recorded. The confidence score, consistency, area under ROC curve, sensitivity and positive predictive value were compared between the two imaging models. Results (1) under Mode 2, the confidence scores of the two radiographers in diagnosing liver cancer increased significantly (P0.05). The area under the ROC curve of the two radiographs under mode 2 was higher than that of the model 1, and the consistency of diagnosis of HCC in mode 2 was higher than that in mode 2. (2) the area under the ROC curve of the two radiographs in the diagnosis of HCC under mode 2 was higher than that in mode 1. The difference was statistically significant (P0.05). (3). The sensitivity of 2). (readers in the diagnosis of liver cancer in mode 2 was higher than that in mode 1. The difference was statistically significant (P0.05), and there was no significant difference in positive predictive value (P0.05). Conclusion Gd-EOB-DTPA MR scan is helpful to improve the diagnostic confidence of Hepatitis B cirrhotic background liver cancer and improve the diagnostic ability.
【作者單位】： 南通大學附屬南通第三醫(yī)院影像科;
【基金】：南通市科技局社會發(fā)展項目(編號:S2013141) 南通市衛(wèi)生局青年基金課題項目(編號:WQ2014039)
【分類號】：R445.2;R735.7

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