增强CT联合MRI检查对脂肪肝背景下局灶结节性病变的诊断价值分析

Value of CT Enhancement Scan Combined with MRI in the Diagnosis of Focal Nodular Lesions in the Context of Fatty Liver

目的探讨增强CT联合MRI检查对脂肪肝背景下局灶结节性病变的诊断价值。方法选取2016年9月—2018年2月我院收治的71例脂肪肝合并局灶结节性病变作为研究对象,所有患者均行增强CT扫描和MRI检查,收集患者的临床资料和影像学资料。分析脂肪肝背景下局灶结节性病变在不同影像学检查中的图像特征,并以病理学检查结果为标准,观察不同检查方式诊断不同性质局灶结节性病变的灵敏度、特异度。结果本组良性结节41例,其中局灶性结节增生17例,肝囊肿16例,肝腺瘤8例;恶性结节30例,其中肝细胞癌22例,胆管细胞癌8例。增强CT扫描正确诊断良性结节35例,6例误诊;MRI检查正确诊断良性结节36例,误诊5例。增强CT扫描正确诊断恶性结节23例,误诊7例;MRI检查正确诊断恶性结节25例,误诊5例。增强CT扫描+MRI检查诊断良性结节、恶性结节的灵敏度、特异度明显高于单一增强CT扫描、MRI检查,差异具有统计学意义(P<0.05)。结论增强CT扫描联合MRI检查可提高脂肪肝背景下局灶结节性病变正确诊断的灵敏度、特异度。

Objective To evaluate the value of CT enhancement scan combined with MRI in the diagnosis of focal nodular lesions in the context of fatty liver.Methods Seventy-one patients with fatty liver and focal nodular lesions admitted to our hospital from September 2016 to February 2018 were selected as the subjects.All patients underwent CT enhancement scan and MRI examination.The clinical data and imaging data of all patients were collected,and the imaging features of focal nodular lesions in the context of fatty liver were analyzed in different imaging examinations.The results of pathological examination were used as the standard to observe the sensitivity and specificity of different examinations in the diagnosis of focal nodular lesions with different nature.Results In this group,41 cases had benign nodules,including 17 cases with focal nodular hyperplasia,16 cases with hepatic cysts and 8 cases with hepatic adenomas.There were 30 cases with malignant nodules,including 22 cases with hepatocellular carcinoma and 8 cases with cholangiocarcinoma.Thirty-five cases with benign nodules were correctly diagnosed by CT enhancement scan,whereas 6 cases were misdiagnosed.Thirty-six cases with benign nodules were correctly diagnosed by MRI,while 5 cases were misdiagnosed.In addition,23 cases with malignant nodules were correctly diagnosed by CT enhancement scan,and 7 cases were misdiagnosed.Twenty-five cases with malignant nodules were correctly diagnosed by MRI,and 5 cases were misdiagnosed.The sensitivity and specificity of CT enhancement scan+MRI in the diagnosis of benign and malignant nodules were significantly higher than those of CT enhancement scan or MRI alone,and the difference was statistically significant(P<0.05).Conclusion CT enhancement scan combined with MRI can improve the diagnostic sensitivity and specificity for focal nodular lesions in the context of fatty liver.