| 宋明月,杜明占,郭凌川,张卫国.平扫及钆塞酸二钠增强MRI鉴别诊断透明细胞型与普通型肝细胞癌[J].中国医学影像技术,2024,40(2):246~250 |
| 平扫及钆塞酸二钠增强MRI鉴别诊断透明细胞型与普通型肝细胞癌 |
| Plain and Gd-EOB-DTPA enhanced MRI for differentiating clear cell and non-otherwise specified hepatocellular carcinoma |
| 投稿时间：2023-10-20 修订日期：2023-11-22 |
| DOI：10.13929/j.issn.1003-3289.2024.02.019 |
| 中文关键词: 癌,肝细胞 磁共振成像 钆塞酸二钠 图像增强 |
| 英文关键词:carcinoma, hepatocellular magnetic resonance imaging gadolinium ethoxybenzyl DTPA image enhancement |
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| 中文摘要: |
| 目的 探讨平扫及钆塞酸二钠（Gd-EOB-DTPA）增强MRI对鉴别诊断透明细胞型肝细胞癌（CCHCC）与普通型肝细胞癌（NOS-HCC）的价值。方法 纳入经手术病理证实的36例CCHCC（CCHCC组）和72例年龄匹配的NOS-HCC患者（NOS-HCC组），以单因素及分析多因素logistic回归分析回顾性评估其临床、病理及上腹部平扫+Gd-EOB-DTPA增强MRI，筛选鉴别CCHCC与NOS-HCC的独立预测因素；绘制受试者工作特征（ROC）曲线，计算曲线下面积（AUC），评价MRI相关独立预测因素及其联合鉴别CCHCC与NOS-HCC的效能。结果 病理Edmondson-Steiner分级及MRI见病灶含脂肪成分、平扫T1WI病灶与肝脏信号强度比值（LLRT1WI）及病灶与肌肉信号强度比值（LMRT1WI）均为CCHCC与NOS-HCC的独立预测因素（P均<0.05）。以病灶含脂肪成分及LLRT1WI、LMRT1WI鉴别CCHCC与NOS-HCC的AUC分别为0.652、0.689、0.687，三者联合的AUC为0.762，高于单一病灶内含脂肪成分（Z=-2.401，P=0.016），而与单一LLRT1WI（Z=-1.841，P=0.066）及LMRT1WI（Z=-1.440，P=0.150）差异均无统计学意义。结论 平扫及Gd-EOB-DTPA增强MRI可用于鉴别CCHCC与NOS-HCC。 |
| 英文摘要: |
| Objective To investigate the value of plain and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI for differentiating clear cell hepatocellular carcinoma (CCHCC) and non-otherwise specified hepatocellular carcinoma (NOS-HCC). Methods Totally 36 CCHCC (CCHCC group) patients and 72 age-matched NOS-HCC (NOS-HCC group) patients were enrolled. Univariate analysis and multivariate logistic regression were used to retrospectively analyze the clinical, pathological and plain upper abdominal MRI as well as Gd-EOB-DTPA enhanced MRI data, so as to screen the independent predictors for distinguishing CCHCC and NOS-HCC. Receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated to evaluate the efficacy of MRI-related independent predictors for distinguishing CCHCC and NOS-HCC individually and in combination. Results Pathologic Edmondson-Steiner grade of HCC, lesions with fat components showed on MRI, the ratio of lesion-to-liver signal intensity on plain T1WI (LLRT1WI) and the ratio of lesion-to-muscle signal intensity on plain T1WI (LMRT1WI) were all independent predictors for distinguishing CCHCC from NOS-HCC (all P<0.05). The AUC of lesions with fat components, LLRT1WI and LMRT1WI for distinguishing CCHCC and NOS-HCC alone was 0.652, 0.689 and 0.687, respectively, and of the combination was 0.762, higher than that of lesions with fat components (Z=-2.401, P=0.016) but not different with AUC of LLRT1WI (Z=-1.841, P=0.066) and LMRT1WI (Z=-1.440, P=0.150) alone. Conclusion Plain and Gd-EOB-DTPA enhanced MRI could be used to distinguish CCHCC and NOS-HCC. |
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