Gd＋-EOB-DTPA与Gd＋-DTPA增强磁共振检查肝细胞癌的对照研究

A compared study on Gd＋-EOB-DTPA and Gd＋-DTPA-enhanced MRI in detection of hepatocellular carcinoma

目的 比较研究Gd＋-EOB-DTPA与Gd＋-DTPA两种增强磁共振对比剂对肝细胞癌检查的准确性.方法 21例肝细胞癌患者术前分别进行Gd＋-EOB-DTPA与Gd＋-DTPA两种增强磁共振检查,以病灶显示质量指数、病灶诊断敏感性、特异性、阳性预测值、阴性预测值、诊断准确率及对比噪声比为指标进行评价,重点比较两种对比剂的差异性.结果 21例肝细胞癌患者共25个病灶,其中＜1.0cm病灶9个.Gd＋-EOB-DTPA增强磁共振检查肝胆特异期呈低信号有24个病灶,仅1个病灶呈等信号.Gd＋-DTPA增强磁共振检查门脉期呈低信号病灶15个、等高信号5个、高信号5个.Gd＋-EOB-DTPA及Gd＋-DTPA增强磁共振检查对于肝细胞癌（特别是＜1.0cm）的病灶显示质量指数,病灶诊断敏感性、特异性、阳性预测值、阴性预测值、诊断正确率分别为17分、89％、89％、89％、89％及12分、33％、33％、33％、67％,肝胆特异期的对比噪声比为：639.35,Gd＋-DTPA动脉期及门脉期对比噪声比分别为：225.25及93.25,Gd＋-EOB-DTPA均优于Gd＋-DTPA增强磁共振检查.结论 采用Gd＋-EOB-DTPA对比剂能较Gd＋-DTPA对比剂更好地显示肝小病灶,可明显提高微小肝细胞癌（＜1.0 cm）诊断正确率.

Objective To evaluate the diiterence of image quality and lesion detection between Gd＊-EOB-DTPA with Gd＋-DTPA-enhanced MRI in cases of hepatocellular carcinoma （HCC）. Methods A total of 21 HCC patients underwent both Gd^-EOB-DTPA and Gd-DTPA-enhanced MRI examination, comparing the difference between the two agents using the value of lesion display quality index, sensitivity, specificity, positive and negative predictive value, diagnosis accuracy and CNR. Results There were 25 lesions on the 21 HCC patients with 9 lesions 〈 1.0 cm. 24 lesions showed hypointensity and 1 lesion showed isointensity on hepatobiliary phase with Gd ~ -EOB-DTPA-enhanced MRI. 15 lesions showed hypoimensily, 5 lesions showed isointensity and 5 lesions showed hyperintensity on portal venous phase with Gd ~ -DTPA-enhanced MRI. The value of lesion （ in particular for the lesion 〈 1.0 cm） display quality index, sensitivity, specificity, positive and negative predictive value, diagnosis accuracy on Gd ＋-EOB-DTPA-enhanced MRI and Gd ^-DTPA-enhanced MRI were 17scors, 89% , 89%, 89% , 89% and 12 scors, 33%, 33%, 33%, 67% respectively. CNR on hepatobiliary phase with Gd＋-EOB-DTPA- enhanced MRI was 639.35. CNR on arterial phase and portal venous phase with Gd ~ -DTPA-enhanced MRI were 225.25 and 93.25 respectively. The data showed that Gd ＋-EOB-DTPA-enhanced MRI was better than that of Gd＋-DTPA-enhanced MRI. Conclusions Gd^-EOB-DTPA-enhanced MRI displays lesions （especially for lesions 〈 1.0 cm） better compared with Gd ~ -DTPA-enhanced MRI increasing the diagnostic accuracy of small HCC.