钆塞酸二钠增强检查在肝硬化背景下小肝癌诊断中的应用

Application of Gd EOB DTPA enhanced examination in the diagnosis of small hepatocellular carcinoma in the context of liver cirrhosis

目的探讨应用钆塞酸二钠(Gd-EOB-DTPA)增强检查肝硬化小肝癌的价值。方法2020年1月至2024年1月延安大学附属医院收治的肝硬化患者72例。均进行Gd-EOB-DTPA肝脏增强核磁共振成像(MRI)扫描,以病理活检结果为金标准,分析Gd-EOB-DTPA MRI增强扫描的图像特征,比较Gd-EOB-DTPA MRI增强扫描用于鉴别诊断肝脏局灶性结节良恶性的效能。结果72例患者经病理活检,共检出肝脏局灶性结节87个,其中良性结节50个(57.47%),恶性结节37个(42.53%);恶性组T1W1低信号、DWI高信号、T2W1高信号、肝胆期低信号、动脉期强化占比均高于良性组(P<0.05)。Gd-EOB-DTPA MRI增强诊断良性结节51个(58.62%),恶性结节36个(41.38%)。Gd-EOB-DTPA增强MRI鉴别诊断小肝癌的准确率为89.66%、敏感度为86.49%、特异度为92.00%、阳性预测值为88.89%、阴性预测值为88.89%、Kappa值=0.788。结论Gd-EOB-DTPA增强检查用于诊断肝硬化背景下小肝癌与金标准的一致性良好,具有临床应用价值。

Objective To explore the value of gadolinium oxalate disodium(Gd EOB DTPA)enhanced examination for small hepatocellular carcinoma(SHCC)in the context of liver cirrhosis.Methods 72 cases of focal liver lesions in the context of liver cirrhosis were included in our hospital from January 2020 to January 2024.Gd EOB DTPA liver enhanced magnetic resonance imaging(MRI)scans were performed on all cases.Using the pathological biopsy results as the gold standard,we observed and analyzed the imaging features of Gd EOB DTPA MRI enhanced scans,and compared the results and efficacy of Gd EOB DTPA MRI enhanced scans in distinguishing between benign and malignant liver focal nodules.Results 72 patients with focal liver lesions underwent pathological biopsy,and a total of 87 focal liver nodules were detected,including 50 benign nodules(57.47%,50/87)(benign group);37 malignant nodules(SHCC)(42.53%,37/87)(malignant group).Compared with the benign group,the malignant group had a higher proportions of T1W1 low signal,DWI high signal,T2W1 high signal,hepatobiliary phase low signal,and arterial phase enhancement(P<0.05);Gd-EOB-DTPA MRI enhanced scans diagnosed 51 benign nodules(58.62%,51/87)and 36 malignant nodules(41.38%,36/87);The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,and Kappa value of Gd-EOB-DTPA enhanced MRI in the differential diagnosis of SHCC were 89.66%,86.49%,92.00%,88.89%,88.89%,and 0.788%,respectively.Conclusion Gd-EOB-DTPA enhanced examination has a good accuracy in diagnosing SHCC in the background of liver cirrhosis,and is consistent with the gold standard,which has a clinical application value.