摘要
目的探索钆塞酸二钠(gadoxetic acid disodium,Gd-EOB-DTPA)增强MRI对鉴别肝脏局灶性慢性炎症病变(focal chronic inflammatory hepatic lesions,FCIHL)与单发肝转移瘤(solitary hepatic metastasis,SHM)的价值。材料与方法回顾性收集广州中医药大学顺德医院2019年6月至2024年2月经病理确诊为FCIHL(23例)与SHM(36例)共59例患者的临床、病理与Gd-EOB-DTPA增强MRI影像学资料。Kappa检验或组内相关系数用于评估每次阅片中两位观察者间一致性。两组间计量资料比较采用独立样本t检验或Mann-Whitney U检验,定性数据用卡方检验进行组间差异分析,组间差异有统计学意义(P<0.05)的特征经单因素和多因素logistic回归分析,确定FCIHL的独立危险因素,并绘制列线图,ROC曲线用于FCIHL与SHM诊断效能分析。结果两位观察者的组间一致性极好,ICC或Kappa值均大于0.8(P<0.05)。ADC值、T2WI与肝胆期病灶直径差值为鉴别FCIHL与SHM的独立影响因素,AUC值分别为0.787(95%CI:0.671~0.904)和0.836(95%CI:0.737~0.936)(P<0.05),列线图的综合AUC值高于单一指标,达到0.908(95%CI:0.836~0.980)。结论Gd-EOB-DTPA增强MRI对鉴别肝脏局灶性慢性炎症病变有一定的价值,其中T2WI与肝胆期病灶直径差值为最具鉴别价值的影像学特征。
Objective:To explore the diagnostic value of gadoxetic acid disodium(Gd-EOB-DTPA)enhanced MRI in differentiating of focal chronic inflammatory hepatic lesions(FCIHL)from solitary hepatic metastasis(SHM).Materials and Methods:The imaging and clinical data of 23 patients with FCIHL and 36 patients with SHM pathologically confirmed in the Shunde Hospital of Guangzhou University of Chinese Medicine from June 2019 to February 2024 were retrospectively collected.All patients underwent diffusion-weighted imaging(DWI)and gadoxetic acid disodium(Gd-EOB-DTPA)enhanced MRI examinations.The imaging characteristics and clinical indicators were compared between the two groups.Kappa test or intra-class correlation coefficient(ICC)was used to assess the consistency between two observers in each image interpretation.For clinical and imaging data of the two groups that conformed to normal distribution,independent samples t-test was adopted;for other continuous data,Mann-Whitney U test was applied;and for categorical data,chi-square test was used to analyze inter-group differences.Logistic regression analysis was conducted on variables with significant inter-group differences(P<0.05)to identify the independent risk factors for FCIHL.A nomogram was constructed,and receiver operating characteristic(ROC)curves were plotted to obtain the area under the curve(AUC)values.Results:Interobserver consistency between the two observers was excellent,with all ICC or Kappa values greater than 0.8(all P<0.05).The apparent diffusion coefficient(ADC)value and the diameter difference of lesions between T2WI and hepatobiliary phase were independent influencing factors for differentiating FCIHL from SHM,with AUC values of 0.787(95%CI:0.671 to 0.904)and 0.836(95%CI:0.737 to 0.936),respectively(both P<0.05).The comprehensive AUC value of the nomogram is higher than that of a single indicator,reaching 0.908(95%CI:0.836 to 0.980).Conclusions:Gd-EOB-DTPA-enhanced MRI has certain value in differentiating FCIHL from SHM.Among these imaging features,the diameter difference of lesions between T2WI and hepatobiliary phase is the most valuable discriminative indicator.
作者
张明玉
朱治
蔡丰灿
吴庆德
欧建宏
ZHANG Mingyu;ZHU Zhi;CAI Fengcan;WU Qingde;OU Jianhong(Department of Medical Imaging,Shunde Hospital of Guangzhou University of Chinese Medicine,Foshan 528329,China;Guangzhou University of Chinese Medicine,Guangzhou 511400,China)
出处
《磁共振成像》
2026年第1期51-58,共8页
Chinese Journal of Magnetic Resonance Imaging
关键词
肝脏
局灶性
慢性炎症
肝脏转移瘤
钆塞酸二钠
磁共振成像
liver
focal
chronic inflammation
liver metastasis
gadoxetic acid disodium
magnetic resonance imaging
