钆贝葡胺磁共振成像对肝细胞癌的诊断价值

摘要

Purpose:To investigate the value of gadobenate dimeglumine (Gd-BOPTA) one-stop dual functional contrast enhanced (DFCE) MRI for focal liver lesions (FLL) detection and hepatocellular carcinoma (HCC) diagnosis.Methods:One hundred and seventeen cases of FLL patients underwent Gd-BOPTA one-stop DFCE-MRI,including MR plain scan (PS),diffusion-weighted imaging (DWI),Gd-BOPTA enhanced multiphase scan (EMS) and hepatobiliary phase scan (HBS).The capabilities of four scanning schemes was assessed in detecting FLL and diagnosing HCC,and four scanning schemes included scheme Ⅰ (PS),scheme Ⅱ (PS + Gd-BOPTA EMS),scheme Ⅲ (PS + DWI + Gd-BOPTA EMS),and scheme Ⅳ (PS + DWI + Gd-BOPTA EMS + HBS,that was:Gd-BOPTA one-stop DFCE-MRI).Results:The detection rate of four scanning schemes from Ⅰ to Ⅳ for FLL were 74.2％,87.4％,98.7％ and 98.7％.There was statistical significant difference between the four groups (P＜0.05),detection rate of PS was significantly lower than the other three contrast enhancement MR (CE-MR) scan schemes.The diagnosis sensitivity,specificity and accuracy of these three CE-MR scanning schemes for HCC from Ⅱ to Ⅳ were 76.2％,70.1％ and 73.1％,92.9％,82.9％ and 85.5％,92.9％,90.5％ and 91.2％ respectively.There was significant difference between the three groups (P＜0.05),and the accuracy of one-stop DFCE-MRI was the highest.Conclusion:The detection rate of Gd-BOPTA one-stop DFCE-MRI for FLL and the diagnostic accuracy for HCC is superior to those of other scanning scheme.Gd-BOPTA one-stop DFCE-MRI can be used as the preferred scanning schemes for the differential diagnosis of hepatocellular carcinoma.%目的:探讨钆贝葡胺(Gd-BOPTA)一站式双功能对比MR成像(DFCE-MRI)对于肝细胞癌(HCC)诊断的价值.方法:对117例肝脏局灶性病变(FLL)患者行Gd-BOPTA一站式DFCE-MRI,包括:①MR平扫;②弥散加权成像(DWI);③Gd-BOPTA多期增强;④肝胆期扫描,比较Ⅰ(①)、Ⅱ(①+③)、Ⅲ(①+②+③)、Ⅳ(①+②+③+④,即:一站式DFCE-MRI)等四种扫描方案对于FLL的检出率和对HCC诊断的敏感性、特异性、准确性.结果:Ⅰ～Ⅳ四种扫描方案对FLL检出率分别为74.2％、87.4％、98.7％和98.7％,四者差异有统计学意义(P＜0.05),方案Ⅰ检出率明显低于其他三种增强扫描方案;Ⅱ～Ⅳ三种增强扫描方案对HCC诊断的敏感度、特异度、准确度分别为76.2％、70.1％和73.1％,92.9％、82.9％和85.5％,92.9％、90.5％和91.2％,三者差异有统计学意义(P＜0.05),且以方案Ⅳ准确度最高.结论:Gd-BOPTA一站式DFCE-MRI对FLL检出率以及对HCC诊断的准确度优于其他扫描方案,可以作为肝细胞癌鉴别诊断的优选MR扫描方案.