MSCT和Gd-EOB-DTPA DCE-MRI诊断肝脏局灶性病变的价值对比

Comparison of MSCT and Gd-EOB-DTPA DCE-MRI in the Diagnosis of Focal Liver Lesions

目的分析多排螺旋CT(MSCT)与钆塞酸二钠动态对比增强磁共振成像(Gd-EOB-DTPA DCE-MRI)对肝脏局灶性病变的诊断价值。方法回顾性分析我院68例经手术病理证实的肝脏局灶性病变患者临床资料。记录68例肝脏局灶性病变患者经手术病理检出的病灶情况,并比较MSCT与Gd-EOB-DTPA DCE-MRI对肝脏局灶性病变性质诊断价值差异。结果68例患者经手术病理共检出病灶228枚,其中恶性病灶182枚(79.82%),良性病灶46枚(20.18%)。MSCT对恶性病灶诊断准确170枚(93.41%),对良性病灶诊断准确36枚(78.26%),共诊断准确206枚(90.35%);Gd-EOB-DTPA DCE-MRI对恶性病灶诊断准确180枚(98.90%),对良性病灶诊断准确40枚(86.96%),共诊断准确220枚(96.49%)。2种检查方法对肝脏局灶性病变患者良恶性病灶诊断的特异度、阳性预测值比较,差异无统计学意义(P>0.05);但MSCT诊断的灵敏度、阴性预测值及准确率均低于Gd-EOB-DTPA DCE-MRI(P<0.05)。结论MSCT和Gd-EOB-DTPA DCE-MRI诊断肝脏局灶性病变均具有较高的诊断价值,但Gd-EOB-DTPA DCE-MRI诊断病灶性质的准确率更高,于临床诊治有利。

Objective To analyze the diagnostic value of multi-slice spiral CT(MSCT)and gadoxetate disodium dynamic contrast-enhanced magnetic resonance imaging(Gd-EOBDTPA DCE-MRI)in the diagnosis of focal liver lesions.Methods The clinical data of 68 patients with focal liver lesions confirmed by operation and pathology were retrospectively analyzed.The lesions conditions of 68 patients with focal liver lesions were recorded by surgery and pathology.The diagnostic value of MSCT and Gd-EOB-DTPA DCE-MRI in the diagnosis of focal liver lesions was compared.Results A total of 228 lesions were detected in 68 patients by operation and pathology,including 182 malignant lesions(79.82%)and 46 benign lesions(20.18%).170(93.41%)malignant lesions and 36(78.26%)benign lesions were accurately diagnosed by MSCT,and a total of 206(90.35%)were accurately diagnosed.80(98.90%)malignant lesions and 40(86.96%)benign lesions were accurately diagnosed by Gd-EOB-DTPA DCE-MRI,and a total of 220(96.49%)were accurately diagnosed.There were no significant differences in the specificity and positive predictive value between the two methods in the diagnosis of benign and malignant lesions of patients with focal liver lesions(P>0.05).However,the sensitivity,negative predictive value and accuracy rate of MSCT diagnosis were lower than those of Gd-EOB-DTPA DCE-MRI(P<0.05).Conclusion MSCT and Gd-EOB-DTPA DCE-MRI both have high diagnostic value in the diagnosis of focal liver lesions.However,Gd-EOB-DTPA DCE-MRI has a higher accuracy rate in diagnosing lesions properties,and it is beneficial for clinical diagnosis and treatment.