首页|平扫及钆塞酸二钠增强MRI鉴别诊断透明细胞型与普通型肝细胞癌

平扫及钆塞酸二钠增强MRI鉴别诊断透明细胞型与普通型肝细胞癌

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目的 探讨平扫及钆塞酸二钠(Gd-EOB-DTPA)增强MRI对鉴别诊断透明细胞型肝细胞癌(CCHCC)与普通型肝细胞癌(NOS-HCC)的价值.方法 纳入经手术病理证实的36例CCHCC(CCHCC组)和72例年龄匹配的NOS-HCC患者(NOS-HCC组),以单因素及分析多因素logistic回归分析回顾性评估其临床、病理及上腹部平扫+Gd-EOB-DTPA 增强MRI,筛选鉴别CCHCC与NOS-HCC的独立预测因素;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评价MRI相关独立预测因素及其联合鉴别CCHCC与NOS-HCC的效能.结果 病理Edmondson-Steiner分级及MRI见病灶含脂肪成分、平扫T1WI病灶与肝脏信号强度比值(LLRT1WI)及病灶与肌肉信号强度比值(LMRT1WI)均为CCHCC与NOS-HCC的独立预测因素(P均<0.05).以病灶含脂肪成分及LLRT1WI、LMRT1WI鉴别CCHCC与NOS-HCC的AUC分别为0.652、0.689、0.687,三者联合的AUC为0.762,高于单一病灶内含脂肪成分(Z=-2.401,P=0.016),而与单一 LLRT1WI(Z=-1.841,P=0.066)及 LMRT1WI(Z=-1.440,P=0.150)差异均无统计学意义.结论 平扫及Gd-EOB-DTPA增强MRI可用于鉴别CCHCC与NOS-HCC.
Plain and Gd-EOB-DTPA enhanced MRI for differentiating clear cell and non-otherwise specified hepatocellular carcinoma
Objective To investigate the value of plain and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI for differentiating clear cell hepatocellular carcinoma(CCHCC)and non-otherwise specified hepatocellular carcinoma(NOS-HCC).Methods Totally 36 CCHCC(CCHCC group)patients and 72 age-matched NOS-HCC(NOS-HCC group)patients were enrolled.Univariate analysis and multivariate logistic regression were used to retrospectively analyze the clinical,pathological and plain upper abdominal MRI as well as Gd-EOB-DTPA enhanced MRI data,so as to screen the independent predictors for distinguishing CCHCC and NOS-HCC.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of MRI-related independent predictors for distinguishing CCHCC and NOS-HCC individually and in combination.Results Pathologic Edmondson-Steiner grade of HCC,lesions with fat components showed on MRI,the ratio of lesion-to-liver signal intensity on plain T1WI(LLRT1WI)and the ratio of lesion-to-muscle signal intensity on plain T1WI(LMRT1WI)were all independent predictors for distinguishing CCHCC from NOS-HCC(all P<0.05).The AUC of lesions with fat components,LLRT1WI and LMRT1WI for distinguishing CCHCC and NOS-HCC alone was 0.652,0.689 and 0.687,respectively,and of the combination was 0.762,higher than that of lesions with fat components(Z=-2.401,P=0.016)but not different with AUC of LLRT1WI(Z=-1.841,P=0.066)and LMRT1WI(Z=-1.440,P=0.150)alone.Conclusion Plain and Gd-EOB-DTPA enhanced MRI could be used to distinguish CCHCC and NOS-HCC.

carcinoma,hepatocellularmagnetic resonance imaginggadolinium ethoxybenzyl DTPAimage enhancement

宋明月、杜明占、郭凌川、张卫国

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苏州大学附属第一医院放射科,江苏苏州 215006

苏州大学附属第四医院放射科,江苏苏州 215028

苏州大学附属第一医院病理科,江苏苏州 215006

癌,肝细胞 磁共振成像 钆塞酸二钠 图像增强

2024

中国医学影像技术
中国科学院声学研究所

中国医学影像技术

CSTPCD北大核心
影响因子:0.763
ISSN:1003-3289
年,卷(期):2024.40(2)
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