钆塞酸二钠增强MRI在慢性肝病合并肝脏结节患者恶性转化风险判断中的应用价值探析

Application value of gadoxetate disodium enhanced MRI in determining malignant transformation risk of patients with chronic liver disease and liver nodules

目的探讨钆塞酸二钠增强MRI在慢性肝病合并肝脏结节患者恶性转化风险判断中的应用价值。方法回顾性分析2018年2月至2020年6月平顶山市第一人民医院收治的94例慢性肝病合并肝脏结节患者的临床资料,所有患者经病理检查证实,并均接受钆塞酸二钠增强MRI扫描。根据病理检查结果将患者分为慢性肝病合并肝脏良性结节组及恶性结节组。比较钆塞酸二钠增强MRI扫描不同时间节点肝脏的对比增强率(CER),探析不同时间节点CER在慢性肝病合并肝脏结节患者恶性转化风险判断中的应用价值。结果病理检查结果显示,94例慢性肝病合并肝脏结节患者中,50例为良性结节,其中19例脂肪瘤,31例血管瘤;44例为恶性结节,其中34例肝细胞癌,10例胆管细胞癌。慢性肝病合并肝脏恶性结节组在钆塞酸二钠增强MRI扫描延迟5 min、10 min、20 min的CER均低于良性结节组(P<0.05)。由受试者工作曲线(ROC)可知,钆塞酸二钠增强MRI扫描延迟5 min、10 min、20 min CER预测肝脏结节恶性风险的AUC分别为0.785、0.816、0.851。结论慢性肝病合并肝脏恶性结节患者的CER较低,使用钆塞酸二钠增强MRI可预测慢性肝病合并肝脏结节患者恶性风险,为临床提供参考。

【Objective】To explore the application value of gadoxetate disodium enhanced MRI in determining malignant transformation risk of patients with chronic liver disease(CLD)and liver nodules.【Methods】The clinical data of 94 patients with CLD and liver nodules who were admitted to the hospital from February 2018 to June 2020 were retrospectively analyzed.All patients were confirmed by pathological examination and underwent gadoxetate disodium enhanced MRI scan.According to the results of pathological examination,patients were divided into benign nodule group and malignant nodule group.The liver contrast enhancement rates(CER)at different time points of gadoxetate disodium enhanced MRI scan were compared.The application value of CER at different time points in determining malignant transformation risk of patients with CLD and liver nodules was explored.【Results】The results of pathological examination showed that among the 94 patients with CLD and liver nodules,there were 50 cases with benign nodules(19 cases with lipoma,31 cases with hemangioma)and 44 cases with malignant nodules(34 cases with hepatocellular carcinoma,10 cases with cholangiocarcinoma).In the chronic liver disease group with malignant liver nodules,CER a t 5 min,10 min and 20 min after the delay of gadoxetate disodium enhanced MRI scan in malignant nodule group were lower than those in benign nodule group(P<0.05).The receiver operating characteristic(ROC)curves showed that AUC values of CER at 5 min,10 min and 20 min after the delay of gadoxetate disodium enhanced MRI for predicting malignant transformation of liver nodules were 0.785,0.816 and 0.851,respectively.【Conclusion】CER are relatively lower in patients with CLD and liver malignant nodules.The gadoxetate disodium enhanced MRI scan can predict the malignant transformation,and provide clini cal reference.