MRI动态增强联合DWI在原发性肝癌中的诊断价值分析

Diagnostic Value of Dynamic Contrast-enhanced MRI Combined with DWI in Primary Liver Cancer

目的:分析MRI动态增强(DCE-MRI)联合弥散加权成像(DWI)在原发性肝癌中的诊断价值。方法:回顾性分析2019年4月-2021年3月某院收治的68例疑似原发性肝癌患者临床资料,入选者均进行MRI平扫、DCE-MRI联合DWI扫查。以手术病理结果作为金标准,分析DCE-MRI联合DWI在原发性肝癌中的诊断价值,计算DCE-MRI、DCE-MRI联合DWI诊断原发性肝癌与病理结果的一致性。另外比较不同性质病变的ADC值。结果:手术病理结果发现,68例疑似原发性肝癌患者中检出40例原发性肝癌,19例肝囊肿,9例肝脏海绵状血管瘤;DCE-MRI联合DWI诊断原发性肝癌灵敏度(97.50%)、特异度(100.00%)、准确度(98.53%)、阳性预测值(100.00%)、阴性预测值(96.55%)均高于DCE-MRI(80.00%、75.00%、77.94%、82.05%、72.41%),差异有统计学意义(P<0.05);DCE-MRI诊断原发性肝癌与病理结果的一致性理想(Kappa=0.547),DCE-MRI联合DWI诊断原发性肝癌与病理结果的一致性极好(Kappa=0.970)。不同病变的ADC值相比,原发性肝癌<肝脏海绵状血管瘤<肝囊肿,差异有统计学意义(P<0.05)。结论:在原发性肝癌患者中采用DCE-MRI联合DWI诊断准确度、灵敏度、特异度均较高,与手术病理结果一致性极好,能够为临床鉴别诊断提供更多参考依据,具有较高的应用价值。

Objective:To analyze the diagnostic value of dynamic contrast-enhanced MRI(DCE-MRI) combined with diffusion-weighted imaging(DWI) in primary liver cancer.Methods:The clinical data of 68 patients with suspected primary liver cancer treated in a hospital from April 2019 to March 2021 were analyzed retrospectively.All the selected patients underwent plain MRI,and DCE-MRI combined with DWI detection.Taking the surgical pathology results as the gold standard,the diagnostic value of DCE-MRI combined with DWI in primary liver cancer was analyzed.In addition,the consistency between DCE-MRI,DCE-MRI combined with DWI in the diagnosis of primary liver cancer and pathological results was calculated.The ADC values of different lesions were compared.Results:The surgical pathology results showed that 40 cases of primary liver cancer,19 cases of hepatic cyst and 9 cases of hepatic cavernous hemangioma were detected in 68 patients with suspected primary liver cancer;The sensitivity(97.50%),specificity(100.00%),accuracy(98.53%),positive predictive value(100.00%) and negative predictive value(96.55%) of DCE-MRI combined with DWI in the diagnosis of primary liver cancer were higher than those of DCE-MRI(80.00%,75.00%,77.94%,82.05% and 72.41%),and the difference was statistically significant(P<0.05).The consistency between DCE-MRI in the diagnosis of primary liver cancer and pathological results is ideal(kappa=0.547),and the consistency between DCE-MRI combined with DWI in the diagnosis of primary liver cancer and pathological results is excellent(kappa=0.970).In the comparison of the ADC values of different lesions,primary liver cancer < hepatic cavernous hemangioma < hepatic cyst,and the difference was statistically significant(P<0.05).Conclusion:DCE-MRI combined with DWI in the treatment of patients with primary liver cancer has high diagnostic accuracy,sensitivity and specificity,and excellent consistency with surgical pathological results,which can provide more reference basis for clinical differential diagnosis and has high application value.