摘要
目的 探究磁共振动态增强扫描成像(Dynamic Contrast-Enhanced Magnetic Resonance Imaging,DCE-MRI)鉴定肝胆期(Hepatobiliary Phase,HBP)高信号肝脏肿块良恶性的价值。方法 回顾性分析三二〇一医院于2022年1月至2024年2月收治的81例HBP高信号肝脏病变患者临床资料,所有患者经穿刺活检或手术确定肿块性质,术前或穿刺前行DCE-MRI检查,对最大下降斜率(Maximum Slope of Decrease,MSD)、正性增强积分(Positive Enhancement Integral,PEI)、平均强化时间(Mean Enhancement Time,MET)以及最大上升斜率(Maximum Slope of Increase,MSI)进行测量,比较不同HBP高信号肝脏肿块性质的MSD、PEI、MET以及MSI,通过受试者工作特征(Receiver Operating Characteristic,ROC)曲线分析DCE-MRI鉴定HBP高信号肝脏肿块性质的价值。结果 81例患者共98个病灶,恶性病变46个,良性病变52个;HBP高信号良性病变患者的PEI、MET、MSI高于HBP高信号恶性病变的患者,差异有统计学意义(P<0.05)。DCE-MRI参数诊断不同HBP高信号肝脏肿块性质的ROC曲线分析结果显示:PEI的曲线下面积(Area Under Curve,AUC)值最高,为0.985,联合诊断的AUC值为0.719。DCE-MRI参数诊断HBP高信号不同肝脏恶性肿块类型的ROC曲线分析结果显示:MSI诊断肝细胞癌的AUC值最高,为0.821;MET诊断肝内胆管癌的AUC值最高,为0.831;MET诊断肝血管瘤的AUC值最高,为0.964;MSI诊断肝转移瘤的AUC值最高,为1.000。结论 DCE-MRI参数在鉴定HBP高信号肝脏肿块性质中具有较高价值,以PEI的效果最佳,且不同DCE-MRI参数在HBP高信号不同肝脏恶性肿块类型中存在较高的诊断效能,临床可结合DCE-MRI参数对HBP高信号肝脏肿块良恶性进行鉴别。
Objective To explore the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in differentiating benign from malignant hyperintense liver masses in the hepatobiliary phase(HBP).Methods A retrospective analysis was performed on the clinical data of 81 patients with HBP hyperintense liver masses admitted to our hospital from January 2022 to February 2024.The nature of the masses was confirmed by biopsy or surgery.All patients underwent DCE-MRI before operation or biopsy.Parameters including maximum slope of decrease(MSD),positive enhancement integral(PEI),mean enhancement time(MET),and maximum slope of increase(MSI)were measured.These parameters were compared between benign and malignant HBP hyperintense liver masses.Receiver operating characteristic(ROC)curves were plotted to analyze the value of DCE-MRI in differentiating the nature of these masses.Results A total of 98 lesions were identified in 81 patients,including 46 malignant and 52 benign lesions.PEI,MET,and MSI in patients with benign HBP hyperintense lesions were significantly higher than those in patients with malignant ones(P<0.05).ROC curve analysis for diagnosing the nature of HBP hyperintense liver masses showed that PEI had the highest area under the curve(AUC)of 0.985,while the combined diagnosis of these parameters had an AUC of 0.719.Specifically,for differentiating subtypes of malignant HBP hyperintense liver masses:MSI showed the highest AUC(0.821)for hepatocellular carcinoma;MET had the highest AUC(0.831)for intrahepatic cholangiocarcinoma;MET exhibited the highest AUC(0.964)for hepatic vascular tumor;and MSI had the highest AUC(1.000)for liver metastases.Conclusion DCE-MRI parameters are of high value in identifying the nature of HBP hyperintense liver masses,with PEI being the most effective.Moreover,these parameters demonstrate high diagnostic efficacy for different types of malignant HBP hyperintense liver masses.Clinically,DCE-MRI parameters can be combined to differentiate benign from malignant HBP hyperintense liver masses.
作者
马宁
周新军
MA Ning;ZHOU Xinjun(Department of Radiology,3201 Hospital,Hanzhong Shaanxi 723000,China)
出处
《中国医疗设备》
2025年第8期139-144,176,共7页
China Medical Devices
基金
2020年医院科研基金项目(3201yk202234)。
