彩色多普勒超声与磁共振成像检查在肝脏局灶性结节性增生病变诊断中的比较

Comparison of color Doppler ultrasound and magnetic resonance imaging in the diagnosis of focal nodular hyperplasia of the liver

目的比较超声与磁共振成像(MRI)检查在肝脏局灶性结节性增生(FNH)病变中的诊断价值。方法选取我院2001年7月~2016年10月的158例行肝细胞穿刺活检检查或经术后病理组织检查结果确诊为FNH的患者作为研究对象,所有患者均给予超声检查、MRI检查以及两者联合检测,并以病理检查结果作为标准,比较不同检查方法对FNH的鉴别和诊断价值。结果病理结果证实158例患者中病灶范围≥50 mm者27例,≥30 mm但<50 mm者31例,≥10 mm但<30 mm者44例,<10 mm者56例;超声对FNH的诊断灵敏度、特异度、准确度分别为91.04%、91.21%、91.14%,MRI对FNH诊断的灵敏度、特异度、准确度分别为92.54%、93.41%、93.04%,超声联合MRI对FNH诊断的灵敏度、特异度、准确度分别为95.52%、96.70%、96.20%;超声和MRI在对≥10 mm的结节诊断准确率比较上,差异无统计学意义(P>0.05);而在<10 mm的结节诊断准确率比较上,MRI的诊断准确率显著高于超声诊断,差异有统计学意义(P<0.05)。结论临床上对FNH的诊断,利用超声能对其进行早期筛选,再通过联合MRI提高确诊率并降低误诊和漏诊率,因此超声诊断在诊断FNH中具有不可替代的作用。

Objective To compare the diagnostic value of ultrasonography and magnetic resonance imaging（MRI） in focal nodular hyperplasia of liver（FNH）.Methods A total of 158 patients diagnosed as focal nodular hyperplasia of liver by biopsy of liver cells or pathological examination after operation from July 2001 to October 2016 were selected as the subjects,all patients were examined by ultrasound,MRI,and combination of both tests,and the result of pathological examination as the standard,the differential diagnosis and diagnosis of focal nodular hyperplastic lesions of the liver was compared.Results The pathological results confirmed that 158 cases of focal nodular hyperplasia of the liver in this study,27 cases of lesions was≥50 mm,31 cases was ≥30 mm but 50 mm,44 cases was ≥10 mm but30 mm,56 cases was 10 mm;The and accuracy of ultrasound in the diagnosis of focal nodular hyperplastic lesions of the liver were 91.04%,91.21%,and 91.14%,respectively,the and accuracy of ultrasound com-bined with MRI in the diagnosis of focal nodular hyperplastic lesions of the liver were 95.52%,96.70%,and 96.20%,respectively.The accuracy rate of ultrasound and MRI in diagnosis of nodules ≥10 mm,the difference was not statistically significant（P〉0.05）;However,in the comparison of the diagnostic accuracy of 10 mm nodules,the diagnostic accuracy of MRI was significantly higher than that of ultrasonic diagnosis,and the difference was statistically significant（P〈0.05）.Conclusion For the diagnosis of focal nodular hyperplasia of the liver,ltrasound can be used for early screening,and combined with magnetic resonance imaging can improve the accuracy of diagnosis and reduce the rate of misdiagnosis and missed diagnosis.Therefore,ultrasound diagnosis has an irreplaceable role in the diagnosis of focal nodular hyperplasia of the liver.