普美显MRI在肝癌早期影像诊断中的应用

Application of Gd-EOB-DTPA enhanced MRI in the early imaging diagnosis of hepatocellular carcinoma

目的探讨普美显核磁共振(MRI)在肝癌早期影像诊断中的应用价值。方法选取2015年1月至2016年6月期间在我院经组织病理学确诊的原发性肝癌患者22例和单纯性肝硬化患者24例作为研究对象,比较两组不同Child-Pugh分级的患者肝脏摄取分数(HEF)值的差异,并比较普美显MRI和MRI平扫诊断肝癌效能的差异,分析普美显MRI定量评估HEF值诊断肝癌的ROC曲线下面积。结果原发性肝癌组患者的HEF值为(84.12±7.16)%,明显高于单纯肝硬化组的(76.49±7.55)%,差异具有统计学意义(P<0.05);普美显MRI诊断肝癌的灵敏度、特异度、阳性预测值、阴性预测值、准确率分别为81.82%、88.00%、85.71%、84.62%、85.11%,均高于MRI平扫的45.45%、60.00%、50.00%、55.56%、53.19%,且差异均有统计学意义(P<0.05);普美显MRI定量评估HEF值诊断肝癌的ROC曲线下面积为91.45%,诊断阈值为81.0%,灵敏度为81.81%,特异度为92.00%,约登指数为0.738。结论普美显MRI诊断肝癌的效能高于MRI平扫,且普美显MRI定量评估HEF值可作为诊断肝癌的指标。

Objective To explore application value of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid（Gd-EOB-DTPA）-enhanced magnetic resonance imaging（MRI） in the early imaging diagnosis of hepatocellular carcinoma.Methods Twenty-two patient with hepatocellular carcinoma（HCC） and twenty-four patients with simple cirrhosis,who admitted to our hospital and detected by histopathological diagnosis from January 2015 to June 2016,were selected as the research objects.The differences of hepatic extraction fraction（HEF） values between the two groups with different Child-Pugh classification were compared.The efficacy of Gd-EOB-DTPA enhanced MRI and MRI plain scan in the diagnosis of HCC was compared,and the area under the ROC curve was used to diagnose HCC by quantitative MRI.Results The value of HEF in primary liver cancer group was（84.12±7.16）%,which was significantly higher than（76.49 ± 7.55）% in simple cirrhosis group（P〈0.05）.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Gd-EOB-DTPA enhanced MRI in the diagnosis of HCC were 81.82%,88.00%,85.71%,84.62%,85.11%,respectively,which was significantly higher than 45.45%,60.00%,50.00%,55.56%,53.19%of MRI plain scan（P〈0.05）.The area under the ROC curve of HEF value for diagnosis of liver cancer by Gd-EOB-DTPA enhanced MRI quantitative assessment was 91.45%,with the diagnostic threshold of 81.00%,the sensitivity of81.81%,the specificity of 92.00%,and the logarithmic index of 0.738.Conclusion The efficiency of Gd-EOB-DTPA enhanced MRI diagnosis of liver cancer is higher than MRI plain scan,and Gd-EOB-DTPA enhanced MRI quantitative assessment of HEF values can be used as an indicator of diagnosis of liver cancer.