| 邢飞,张学琴,缪小芬,张涛,邢伟.非动脉期高强化的肝胆期低信号肝硬化结节富血供转变危险因子[J].中国医学影像技术,2022,38(2):226~231 |
| 非动脉期高强化的肝胆期低信号肝硬化结节富血供转变危险因子 |
| Risk factors of hypervascular transformation of hepatobiliary phase hypointense cirrhotic nodules without arterial phase hyperenhancement |
| 投稿时间：2021-05-13 修订日期：2021-09-28 |
| DOI：10.13929/j.issn.1003-3289.2022.02.015 |
| 中文关键词: 肝肿瘤 肝硬化 肝炎,乙型,慢性 磁共振成像 对比剂 |
| 英文关键词:liver neoplasms liver cirrhosis hepatitis B, chronic magnetic resonance imaging contrast media |
| 基金项目: |
|
| 摘要点击次数: 1921 |
| 全文下载次数: 572 |
| 中文摘要: |
| 目的 观察钆塞酸二钠（Gd-EOB-DTPA）增强MRI示非动脉期高强化（APHE）的肝胆期（HBP）低信号肝硬化结节发生富血供转变的危险因子。方法 回顾性分析64例接受2次及以上Gd-EOB-DTPA增强MR扫描的慢性乙型肝炎、肝硬化患者，首诊MRI检出83个非APHE的HBP低信号结节；根据随访期间增强MRI所示动脉期（AP）结节有无高强化，将其分为富血供转变组（n=25）及非富血供转变组（n=58）；对比2组患者临床资料及结节MRI征象，绘制Kaplan-Meier曲线分析结节富血供转变的发生率，采用Cox回归分析观察结节富血供转变的危险因子。结果 随访期间富血供转变组88.00%（22/25）结节增大，其中54.54%（12/22） DWI或T2WI呈高信号；非富血供转变组55.17%（32/58）结节增大，其中15.63%（5/32） DWI或T2WI呈高信号。2组患者病史、DWI或T2WI结节是否呈高信号及结节增长率均存在显著差异（P均<0.05）。以0.60×10－3/天为结节增长率的最佳截断值，其预测结节发生富血供转变的敏感度为72.00%，特异度为87.93%，曲线下面积（AUC）为0.83（95%CI 0.73~0.90，P<0.01）。Cox回归分析结果显示，DWI或T2WI呈高信号及增长率≥0.60×10－3 /天为结节发生富血供转变的危险因子。结论 Gd-EOB-DTPA增强MRI表现为非APHE的HBP低信号肝硬化结节于DWI或T2WI呈高信号及增长率≥0.60×10－3 /天为其发生富血供转变的危险因子。 |
| 英文摘要: |
| Objective To explore the risk factors of hypervascular transformation of hepatobiliary phase (HBP) hypointense cirrhotic nodules without arterial phase hyperenhancement (APHE) on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI. Methods Data of 64 with chronic hepatitis B patients combined with liver cirrhosis who underwent Gd-EOB-DTPA enhanced MR scanning twice or more were retrospectively analyzed, and HBP hypointense nodules without APHE were detected with initial MRI. The nodules were divided into hypervascular transformation group (n=25) and non hypervascular transformation group (n=58) according to with or without high enhancement in arterial phase (AP) on enhanced MRI during follow-up period. Clinical data of patients and MRI signs of nodules were compared between groups. Kaplan-Meier curve was used to analyze the incidence of hypervascular transformation of nodules. The risk factors of hypervascular transformation were explored with Cox regression analysis. Results During follow-up period, in hypervascular transformation group, 88.00% (22/25) nodules enlarged, among which 54.54% (12/22) showed hyperintensity on DWI or T2WI, while in non hypervascular transformation group, 55.17% (32/58) nodules enlarged, among which 15.63% (5/32) showed hyperintensity on DWI or T2WI. There were significant differences of history of hepatocellular carcinoma (HCC), nodule with or without hyperintensity on DWI or T2WI and the growth rate of nodules between groups (all P<0.05). Taken 0.60×10-3/day as the best cut-off value of nodule growth rate for predicting hypervascular transformation, the sensitivity was 72.00%, specificity was 87.93%, and the area under the curve (AUC) was 0.83 (95%CI 0.73-0.90, P<0.01). Cox regression analysis showed that hyperintensity on DWI or T2WI and growth rate ≥ 0.60×10-3/day were risk factors of hypervascular transformation of nodules. Conclusion Hyperintensity on DWI or T2WI and growth rate ≥ 0.60×10-3/day of HBP hypointense cirrhotic nodules without APHE on Gd-EOB-DTPA enhanced MRI were risk factors of hypervascular transformation. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
