摘要
目的探讨肝脏磁共振成像(MRI)增强扫描征象辅助肝脏影像报告和数据系统(LIRADS)对肝脏肿瘤定性的评估价值。方法选取2020年1月至2023年12月在厦门大学附属第一医院收治的120例肝脏肿瘤患者,所有患者均接受手术病理检查,肝脏MRI增强扫描,并接受肝脏影像报告和数据系统(LIRADS)评估,将MRI增强扫描征象和LIRADS对患者的诊断结果和病理结果进行对比,分析联合诊断对肝脏肿瘤的定性价值。通过单因素与多因素logistic回归分析确定诊断恶性病灶的独立预测因素。结果病理检查结果显示:120例患者共存在126个病灶,其中恶性病灶97个,良性29个。肝脏MRI增强扫描检测诊断准确率为79.38%,LI-RADS诊断准确率为71.13%,联合诊断准确率为91.75%,联合诊断准确率高于单独检测(P<0.05)。恶性病灶组瘤内坏死/囊变、不光滑肿瘤边缘、环形动脉期高强化和靶样扩散受限发生率较良性组高,动脉期明显强化发生率较良性组低,良性组肝胆期RER水平较恶性病灶组高,差异有统计学意义(P<0.05)。多因素logistic回归分析发现:不光滑肿瘤边缘、肝胆期增强定量参数和环形动脉期高强化为恶性病灶诊断的独立评估因素(P<0.05)。结论肝脏MRI增强扫描征象辅助LIRADS对肝脏肿瘤定性评估具有较高的准确性。
Objective To explore the value of liver imaging reporting and data system(LIRADS)assisted with liver magnetic resonance imaging(MRI)enhanced scan signs in the qualitative evaluation of liver tumors.Methods A total of 120 patients with liver tumors admitted to the First Affiliated Hospital of Xiamen University were enrolled between January 2020 and December 2023.All patients underwent surgical pathological examination,liver MRI enhanced scan and LIRADS evaluation.The diagnostic results by MRI enhanced scan signs,LIRADS and pathological examination were compared.The qualitative value of combined detection for liver tumors was analyzed.The independent predictors of malignant lesions were determined by univariate and multivariate Logistic regression analysis.Results The results of pathological examination showed that there were 126 lesions in 120 patients,including 97 malignant lesions and 29 benign lesions.The diagnostic accuracy rate of liver MRI enhanced scan,LI-RADS and combined detection were 79.38%,71.13%and 91.75%,respectively.The diagnostic accuracy rate of combined detection was higher than that of single index(P<0.05).The incidence of intratumoral necrosis/cystic degeneration,non-smooth tumor margin,high enhancement in annular artery stage and limited target diffusion in malignant lesion group was higher than that in benign group,incidence of obvious enhancement in arterial stage was lower than that in benign group,and RER level in hepatobiliary stage was lower than that in benign group(P<0.05).Multivariate Logistic regression analysis showed that the non-smooth tumor margin,enhancement quantitative parameters in hepatobiliary stage and high enhancement in annular artery stage were independent evaluation factors in the diagnosis of malignant lesions(P<0.05).Conclusion LI-RADS assisted with liver MRI enhanced scan signs has high accuracy in the qualitative evaluation of liver tumors.
作者
黄春嘉
刘旭俊
孙晓明
HUANG Chun-jia;LIU Xu-jun;SUN Xiao-ming(Department of Radiology and Imaging,the First Affiliated Hospital of Xiamen University,Xiamen 361001,Fujian Province,China)
出处
《中国CT和MRI杂志》
2025年第9期108-111,共4页
Chinese Journal of CT and MRI
基金
福建省卫生健康科技计划项目(2021QN0106)。
关键词
肝脏
磁共振成像增强扫描
肝脏成像报告和数据系统
肝脏肿瘤
Liver
Magnetic Resonance Imaging Enhanced Scan
Liver Imaging Reporting And Data System
Liver Tumor
