胆囊窝扩大的MRI征象对肝硬化诊断的价值

MRI Evaluation of Expanded Gallbladder Fossa in Liver Cirrhosis

目的 评价胆囊窝扩大MRI征象对肝硬化诊断的敏感性和特异性。方法 本文收集临床证实的肝硬化患者 6 1例 ;同时收集同期无肝硬化病史病例 80例作为对照组 ,将病变组和对照组的病例随机混合 ,不提供临床病史分别由两位有多年MR诊断经验的医师独立阅片 ,确定有无胆囊窝扩大征 ;计算胆囊窝扩大的MRI征象对肝硬化诊断的准确性、敏感性、特异性、阳性预检值和阴性预检值。结果 ①医师I阅片结果显示 :胆囊窝扩大的MRI征象对肝硬化诊断的准确性为 86 %、敏感性为 70 %、特异性为 98%、阳性预检值为 96 % ;②医师II阅片结果显示 :胆囊窝扩大的MRI征象对肝硬化诊断的准确性为 84%、敏感性为 74%、特异性为 93%、阳性预检值为 88%。结论 胆囊窝扩大MRI征象在肝硬化中较常见 。

Purpose To evaluate MRI sign of expanded gallbladder fossa in cirrhosis and to assess the sensitivity and specificity of this sign for cirrhosis. Methods One hundred and forty one patients who underwent MR imaging were included in this study, including 61 with clinically proved cirrhosis(cirrhosis patients) and 80 without history of chronic liver diseases(control subjects). MR images were qualitatively evaluated by two independent observers(Observer I/Observer II) for the presence of the expanded gallbladder fossa sign. This sign was considered present if there was enlargement of the pericholecystic space (ie, gallbladder fossa) and the space was bounded laterally by the edge of the right hepatic lobe and medially by the edge of the left lateral segment, in conjunction with nonvisualization of the left medial segment. Results The accuracy, sensitivity, specificity, and positive predictive value of expanded gallbladder fossa for the MR diagnosis of cirrhosis were 86%/84%, 70%/74%, 98%/93% and 96%/88%, respectively(Observer I/Observer II). Conclusion The expanded gallbladder fossa sign on MR images is frequently present, specific indicator of cirrhosis.