小肝癌的MRI特征及诊断价值分析
MRI Characteristics and Diagnostic Value in Small Hepatocellular Carcinoma
李佳 1冯硕 2马继征3
作者信息
- 1. 中国中医科学院广安门医院南区放射科(北京 102618)
- 2. 中国中医科学院广安门医院南区循证医学中心(北京 102618)
- 3. 中国中医科学院广安门医院消化科(北京 100053)
- 折叠
摘要
目的 探讨小肝癌(SHCC)的增强磁共振成像(MRI)特征并分析其诊断价值.方法 选取2018年7月～2023年5月在本院收治的疑似SHCC患者63例作为研究对象,所有患者均行增强MRI与MRI平扫检查,以手术病理结果或病理活检为"金标准",采用Kappa-致性检验,比较两种检查方式对SHCC的诊断价值,采用单因素和多因素Logistic回归分析确定SHCC的因素.结果 63例疑似SHCC患者中共46例(73.02％)SHCC阳性,17例阴性.MRI平扫的确诊率78.26％(36/46)低于增强MRI确诊率93.48％(43/46)(P＜0.05).MRI平扫时T1WI序列以低信号居多,T2WI序列以高信号和略高信号为主;增强MRI扫描时,动脉期明显强化,门静脉期和延迟期强化下降,信号降低.MRI平扫诊断SHCC的灵敏度、特异度、准确率、阳性预测值、阴性预测值和Kappa系数值分别为78.26％、82.35％、79.37％、92.31％、58.33％和0.536,增强MRI诊断SHCC的灵敏度、特异度、准确率、阳性预测值、阴性预测值和Kappa系数值分别为93.48％、94.11％、93.65％、97.73％、84.21％和0.845,其中增强MRI诊断的灵敏度和准确率均高于MRI平扫(P均＜0.05).Logistic回归分析,结果显示MRI平扫T1WI序列低信号、T2WI序列高信号或略高信号、MRI增强扫描动脉期明显强化、门静脉期信号降低均为诊断SHCC阳性的独立危险因素(P＜0.05).结论 较于MRI平扫检查,增强MRI检查对SHCC的诊断价值更高,具良好的应用价值.
Abstract
Objective To analyze the characteristics of contrast-enhanced magnetic resonance imaging(MRI)and its diagnostic value in small hepatocellular carcinoma(SHCC).Methods A total of 63 patients with suspected SHCC admitted to the hospital were enrolled as the research objects between July 2018 and May 2023.All underwent contrast-enhanced MRI and MRI plain scan.Taking the results of surgical pathology or pathological biopsy as the golden standard,diagnostic value of the two detection methods for SHCC was compared by Kappa consistency test.The risk factors of SHCC were determined by univariate and multivariate Logistic regression analysis.Results In the 63 patients with suspected SHCC,there were 46 cases(73.02％)with SHCC positive and 17 cases with negative.The confirming rate of MRI plain scan was lower than that of contrast-enhanced MRI[78.26％(36/46)vs 93.48％(43/46),P＜0.05].In MRI plain scan,low signals were in the majority on T1WI sequence,while high and slightly high signals were in the majority on T2WI sequence.In contrast-enhanced MRI scan,there was significant enhancement in arterial phase,while the enhancement was declined in portal vein phase and delayed phase,with signal decrease.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Kappa coefficient of MRI plain scan and contrast-enhanced MRI in the diagnosis of SHCC were(78.26％,82.35％,79.37％,92.31％,58.33％,0.536)and(93.48％,94.11％,93.65％,97.73％,84.21％,0.845),respectively.The diagnostic sensitivity and accuracy of contrast-enhanced MRI were higher than those of MRI plain scan(P＜0.05).The results of Logistic regression analysis showed that low signal on T1WI sequence,high or slightly high signal on T2WI sequence in MRI plain scan,significant enhancement in arterial phase and signal decrease in portal vein phase in contrast-enhanced MRI scan were all independent risk factors in the diagnosis of SHCC positive(P＜0.05).Conclusion Compared with MRI plain scan,contrast-enhanced MRI has higher diagnostic value for SHCC.
关键词
增强磁共振成像/磁共振成像平扫/小肝癌/诊断/特征Key words
Contrast-enhanced Magnetic Resonance Imaging/Magnetic Resonance Imaging Plain Scan/Small Hepatocellular Carcinoma/Diagnosis/Characteristics引用本文复制引用
基金项目
北京市中医药科技发展资金项目(2023)(JJ-2023-115)
出版年
2024
NETL
NSTL
万方数据