钆塞酸二钠增强MRI中动脉减影图像诊断肝细胞癌的价值

Value of Arterial Subtraction Images in Gadoxetate Disodium-enhanced MRI in the Diagnosis of Hepatocellular Carcinoma

目的探究钆塞酸二钠增强MRI中动脉减影图像诊断肝细胞癌(HCC)的价值。方法回顾性分析2020年6月-2022年6月在菏泽市立医院接受钆塞酸二钠增强MRI检查的97例患者临床资料。比较不同结节病种、结节平扫T1WI信号间动脉期图像与动脉减影图像Nonrim APH检出率以及动脉图像与减影图像对LR-5分类的敏感性和特异性,并评估动脉减影图像在LI-RADS诊断HCC中的价值。结果排除2例不符合图像要求的患者,共124个结节,包括81个HCC、20个其他恶性肿瘤、23个良性结节。动脉减影图像Nonrim APHE检出率为70.97%,高于动脉期图像的53.23%,差异有统计学意义(P<0.05)。在亚组分析中,HCC动脉减影图像Nonrim APHE检出率高于动脉期图像,差异有统计学意义(P<0.05),而非HCC恶性肿瘤和良性结节动脉期图像与动脉减影图像Nonrim APHE检出率比较,差异无统计学意义(P>0.05);T1WI低信号和T1WI等高信号动脉减影图像Nonrim APHE检出率均高于动脉期图像,差异有统计学意义(P<0.05)。当LR-5被视为HCC时,动脉减影图像诊断HCC的敏感性较动脉期图像增加(P<0.05),而特异性降低,但差异无统计学意义(P>0.05);当LR-4和LR-5均被视为HCC时,动脉期图像和动脉减影图像敏感性和特异性比较,差异无统计学意义(P>0.05)。结论动脉减影图像可提高钆塞酸二钠增强MRI对Nonrim APHE的检出率。当应用LI-RADS诊断HCC时,动脉减影图像可提高灵敏度,而不会降低特异性。

Objective To explore the value of arterial subtraction images in gadoxetate disodium-enhanced MRI in the diagnosis of hepatocellular carcinoma.Methods The clinical data of 97 patients who underwent gadoxetate disodium-enhanced MRI in Heze Municipal Hospital from June 2020 to June 2022 were retrospectively analyzed.The detection rate of Nonrim APH in arterial phase images and arterial subtraction images between T1WI signals of different sarcoidosis types and nodules,the sensitivity and specificity of arterial images and subtraction images for LR-5 classification were compared,and the value of arterial subtraction images in LI-RADS diagnosis of HCC was evaluated.Results Excluding 2 patients who did not meet the image requirements,a total of 124 nodules,including 81 HCC,20 other malignant tumors,and 23 benign nodules.The detection rate of Nonrim APHE in arterial subtraction images was 70.97%,which was higher than 53.23% in arterial phase images(P<0.05).In the subgroup analysis,the detection rate of Nonrim APHE in HCC arterial subtraction images was higher than that in arterial phase images,and the difference was statistically significant(P<0.05).There was no significant difference in the detection rate of Nonrim APHE between arterial phase images and arterial subtraction images of non-HCC malignant tumors and benign nodules(P>0.05).The detection rate of Nonrim APHE in arterial subtraction images of T1WI low signal and T1WI equal high signal was higher than that in arterial phase images,and the difference was statistically significant(P<0.05).When LR-5 was considered as HCC,the sensitivity of arterial subtraction imaging in the diagnosis of HCC was higher than that of arterial phase imaging(P<0.05),while the specificity was lower,but the difference was not statistically significant(P>0.05).When LR-4 and LR-5 were regarded as HCC,there was no significant difference in sensitivity and specificity between arterial phase image and arterial subtraction image(P>0.05).Conclusion Arterial subtraction images can improve the detection rate of nonrim APHE by gadoxetate disodium-enhanced MRI.When LI-RADS is used to diagnose HCC,arterial subtraction images can improve sensitivity without reducing specificity.