双功能造影剂钆贝葡胺增强MRI对肝硬化结节的临床诊断价值

Clinical Study of Gadobeglumine Difunctional Contrast Agent Enhanced MRI in Cirrhotic Nodules

目的:分析双功能Gd-BOPTA增强MRI对肝硬化结节的临床价值。方法:选取2020年1月1日—2021年12月31日于中山大学附属第三医院粤东医院收治的60例肝硬化结节患者,分别行Gd-BOPTA增强MRI扫描检查和钆喷葡胺(Gd-DTPA)增强MRI扫描检查,以患者术后的病理学检测结果为金标准,评估行Gd-BOPTA增强MRI和Gd-DTPA增强MRI检查肝硬化结节患者早期肝癌的检出率,比较各种检查方法与金标准诊断结果的一致性,并对各组检测方法的诊断效能进行统计对比,同时对两种检查方法检出结节的指标结果进行对比。结果:经术后组织病理学检测显示,60例肝硬化结节患者中恶性52例、良性8例;Gd-BOPTA增强MRI检出恶性率高于Gd-DTPA增强MRI(P<0.05)。Gd-BOPTA增强MRI检出结果与金标准有高度一致性(Kappa=0.891)。Gd-BOPTA增强MRI诊断的各项诊断效能指标均高于Gd-DTPA增强MRI诊断(P<0.05)。Gd-BOPTA增强MRI检出的恶性结节体积、人均结节检出数均高于Gd-DTPA增强MRI(P<0.05)。结论:双功能造影剂钆贝葡胺增强MRI能明显增加肝硬化结节恶性癌变的检出率,提高诊断的正确性,能够早期发现癌灶,无创评估肝脏储备功能,临床诊断价值较高。

Objective:To analyze the clinical value of dual-function Gd-BOPTA enhanced MRI in cirrhotic nodules.Methods:Sixty patients with liver cirrhosis nodules admitted to Yuedong Hospital,Third Affiliated Hospital of Sun Yat-sen University from January 1,2020 to December 31,2021 were selected and examined by Gd-BOPTA enhanced MRI and Gd-DTPA enhanced MRI,respectively.The detection rate of early liver cancer in patients with liver cirrhosis nodules examined by Gd-BOPTA enhanced MRI and Gd-DTPA enhanced MRI was evaluated based on the postoperative pathological test results of patients as the gold standard.The consistency between various examination methods and the gold standard diagnosis results was compared,and the diagnostic efficacy of each group of detection methods was statistically compared.Meanwhile,the index results of nodules detected by the two methods were compared.Results:Postoperative histopathological examination showed that 52 cases were malignant and 8 cases were benign in 60 patients with cirrhosis nodules.The malignant detection rate of Gd-BOPTA enhanced MRI was higher than that of Gd-DTPA enhanced MRI(P<0.05).Gd-BOPTA enhanced MRI detection results were highly consistent with gold standard(Kappa=0.891).The diagnostic efficacy indexes of Gd-BOPTA enhanced MRI were higher than those of Gd-DTPA enhanced MRI(P<0.05).The volume of malignant nodules and the number of nodules per capita detected by Gd-BOPTA enhanced MRI were higher than those by Gd-DTPA enhanced MRI(P<0.05).Conclusion:Bifunctional contrast agent Gd-DTPA enhanced MRI can significantly increase the detection rate of malignant canceration of liver cirrhosis nodules,improve the accuracy of diagnosis,early detection of cancer foci,noninvasive assessment of liver reserve function,and have high clinical diagnostic value.