摘要
目的前瞻性评价菲立磁增强扫描对局灶性肝病的检出价值及其病理基础。方法收集经临床、手术病理为诊断金标准证实的26例61个肝局灶性病变,前瞻性对比评价螺旋CT增强扫描、MRI平扫及联合分析MRI平扫+菲立磁增强图像对局灶性肝病的诊断价值。其中20例32个病灶行免疫组化抗CD-68染色,并计数各局灶性病变的Kupffer细胞计数比率。结果螺旋CT增强扫描、MRI平扫及联合分析MRI平扫+菲立磁增强诊断敏感性分别为72%、82%、93%,P<0·05;特异性分别为92%、96%、96%,P>0·05,准确性分别为78%、86%、94%,P<0·05。良性局灶性肝病与恶性病灶包括高分化、中分化、低分化HCC的Kupffer细胞计数比率存在不同,分别为1·54±0·47、0·74±0·30、0·32±0·09、0·28±0·07,差异有显著性(P<0·05)。结论菲立磁增强MRI对肝局灶性病变的检出价值优于螺旋CT增强扫描。局灶性病变与非肿瘤区肝组织内Kupffer细胞含量的差异是菲立磁增强MRI病灶检出的病理基础。
Objective To determine the value of Feridex-enhanced MRI for detection of focal hepatic lesions and analyze its relevant pathological basis. Methods The images obtained by MRI and CT in 26 patients with pathologically and clinically confirmed 61 focal hepatic lesions were prospectively analyzed to compare the detection value among 3 different methods of enhanced helical CT, Feridexenhanced MRI and unenhaneed and Feridex-enhaneed MRI. Thirty-two hepatic lesions in 20 patients were stained by immunohistoehemleal method to calculate the Kupffer-eell-eount ratio of each focal lesion. Results For the enhanced helical CT group, Feridex-enhaneed MRI group and unenhaneed and Feridex-enhaneed MRI group, the diagnostic sensitivity was 72%, 82% and 93% （P〈0.05）, specificity 92%, 96% and 96% （P〉0.05） and accuracy 78%, 82% and 93% （P〈0.05）, respectively. The Kupffer-cell-count ratio was 1.54±0.47, 0. 74±0. 30, 0. 32±0. 09 and 0. 28±0. 07 for the benign focal hepatic lesions, well-differentiated HCC, moderately differentiated HCC and poorly differentiated HCC, respectively. There was significant difference in the Kupffer-cell-count ratio between the benign focal hepatic lesions and malignant ones （P〈0. 05）. Conclusions Feridex-enhanced MRI is superior to enhanced helical CT in detection of focal hepatic lesions. The differences in Kupffer-cellcount ratio and focal lesions are the pathological basis for Feridex-enhanced MRI to detect the lesions.
出处
《中华肝胆外科杂志》
CAS
CSCD
2005年第12期793-796,共4页
Chinese Journal of Hepatobiliary Surgery
