| 陈静静,石祥龙,华辉,纪清连,李颖端,司友娇.磁共振动态增强扫描定量指标诊断肝脏占位性病变[J].中国医学影像技术,2015,31(1):72~76 |
| 磁共振动态增强扫描定量指标诊断肝脏占位性病变 |
| Quantitative parameters of dynamic contrast-enhanced MRI in diagnosis of hepatic mass |
| 投稿时间：2014-07-22 修订日期：2014-11-04 |
| DOI：10.13929/j.1003-3289.2015.01.021 |
| 中文关键词: 肝肿瘤 磁共振成像 对比剂 |
| 英文关键词:Liver neoplasms Magnetic resonance imaging Contrast media |
| 基金项目:山东省科技发展计划项目(2011YD18034)。 |
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| 中文摘要: |
| 目的 探讨3.0T MR多期动态增强(MDCE-MRI)所获定量及半定量参数对肝脏占位性病变定性诊断的价值。方法 回顾性分析经手术或穿刺活检病理证实的80例肝脏占位性病变患者,所有病变均于手术或穿刺活检前采用3.0T MR扫描仪行MDCE扫描,测量病变的平均强化时间(MET)、正性增强积分(PEI)、最大上升斜率(MSI)、最大下降斜率(MSD)及强化曲线类型。先比较各参数在良恶性病变间的差异,然后比较各参数在各种病变间的差异。采用ROC曲线分析各参数值对肝脏占位性病变良恶性的鉴别诊断效能;并采用Logistic回归分析计算回归方程,得出鉴别诊断的临界点。结果 肝脏良、恶性肿瘤MET、PEI、MSI及强化曲线类型间的差异均有统计学意义;血管瘤与肝癌、胆管细胞癌、转移瘤PEI、MSI的差异有统计学意义;转移瘤与肝癌、血管瘤MSD的差异有统计学意义;MET、PEI、MSI参数的ROC曲线下面积分别为0.70、0.72、0.80;各参数诊断的特异度均为77.0%,敏感度分别为58.8%、70.6%、82.4%;经Logistic回归分析,得出回归方程:P=1/(1+e0.008X1+0.007X2－6.707),取约登指数最大点作为诊断点,即0.2946。结论 MDCE-MRI的强化曲线类型及量化参数对鉴别肝脏良、恶性病变具有一定的应用价值。 |
| 英文摘要: |
| Objective To explore the value of some quantitative and semi-quantitative parameters of multiphase dynamic contrast-enhanced magnetic resonance imaging (MDCE-MRI) in diagnosis of hepatic mass. Methods Totally 80 patients with hepatic mass pathologically confirmed by surgery or biopsy were retrospectively analyzed. All patients underwent MDCE-MRI at 3.0T MR before treatment. The curve types of MDCE-MRI and some parameters of the lesions including mean enhancement time (MET), positive enhancement integral (PEI), maximum slop of increase (MSI) and maximum slop of decrease (MSD), were respectively measured and compared between benign and malignant hepatic mass. The differences of the quantitative and semi-quantitative parameters in different hepatic mass were also compared. ROC curves were made to investigate the efficiency of these parameters. Regression equation and the critical point of differential diagnosis were obtained by using the Logistic regression analysis. Results There were significant differences between benign and malignant hepatic mass in MET, PEI, MSI values and the curve types. The PEI, MSI values between hemangioma and hepatocellular carcinoma (HCC), cholangiocarcinoma, metastases had significant difference, as well as the corresponding of curve types. MSD value between metastases and HCC, hemangioma had significant difference. The area under curve (AUC) of MET, PEI, MSI were 0.70, 0.72, 0.80. The specificity of MET, PEI and MSI were all 77.0%, the sensitivity were 58.8%, 70.6%, 82.4% retrospectively. By Logistic regression analysis showed the regression equation were P=1/(1+e0.008X1+0.007X2－6.707), and taking about an average maximum points as a diagnostic point, that was 0.2946. Conclusion As a noninvasive magnetic resonance imaging, some quantitative and semi-quantitative parameters of MDCE-MRI play a great role in differentiating hepatic mass. |
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