Gd-EOB-DTPA对比增强与DWI两种成像方法诊断小肝细胞癌的临床价值

doi:10.3969/j.issn.1671-7171.2021.12.011

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摘要【目的】探讨磁共振肝细胞特异性对比剂(Gd-EOB-DTPA)对比增强与扩散加权成像(DWI)两种成像方法联合诊断小肝细胞癌(sHCC)的价值。【方法】选择2016年11月至2020年12月本院收治的83例经超声或CT诊断存在肝占位病变且疑似sHCC患者的临床资料,患者均在常规影像学基础上行Gd-EOB-DTPA对比增强(肝胆期、门脉期及动脉期)影像联合DWI影像诊断。以病理结果为金标准,根据检测结果的工作特性曲线(ROC),比较不同影像检查方法sHCC阳性检出率,并根据曲线下面积大小(AUC)判定其准确性。【结果】83例患者中53例病理学检查确诊为阳性sHCC;Gd-EOB-DTPA诊断结果显示阳性sHCC患者 33例,阴性sHCC 患者20例;DWI诊断结果显示阳性sHCC患者34例,阴性sHCC 患者22例;Gd-EOB-DTPA联合DWI诊断结果显示阳性sHCC 患者45例,阴性sHCC患者 27例;Gd-EOB-DTPA诊断及DWI诊断阳性检出率均低于Gd-EOB-DTPA联合DWI诊断(P<0.05),Gd-EOB-DTPA诊断阳性检出率较DWI诊断差异无统计学意义(P>0.05);Gd-EOB-DTPA联合DWI诊断AUC为0.875,高于Gd-EOB-DTPA或DWI单一诊断AUC。【结论】Gd-EOB-DTPA对比增强与DWI两种成像方法联合诊断sHCC,能够有效提高sHCC阳性检出率,诊断效能较好。

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	曾飞祥
	毛思鑫
	吴伟军

关键词 ：癌,肝细胞/影像诊断, 放射性核素显像/方法, 磁共振成像/方法

Abstract：【Objective】Objective to investigate the value of contrast-enhanced and diffusion-weighted imaging (DWI) with liver cell specific contrast agent (GD-EOB-DTPA) in the diagnosis of small hepatocellular carcinoma (sHCC). 【Methods】The clinical data of 83 patients with suspected HCC diagnosed by ultrasound or CT from November 2016 to December 2020 were selected, All patients were diagnosed by GD-EOB-DTPA contrast-enhanced (hepatobiliary phase, portal phase and arterial phase) combined with DWI on the basis of conventional imaging. Taking the pathological results as the gold standard, the positive detection rates of sHCC by different imaging methods were compared according to the working characteristic curve (ROC) of the test results, and the accuracy was determined according to the area under the curve (AUC).【Results】 Fifty three of 83 patients were diagnosed as positive sHCC by pathological examination; The diagnostic results of GD-EOB-DTPA showed that there were 33 patients with positive sHCC and 20 patients with negative sHCC; The results of DWI showed that there were 34 patients with positive SHCC and 22 patients with negative SHCC; The diagnostic results of GD-EOB -DTPA combined with DWI showed that there were 45 patients with positive sHCC and 27 patients with negative sHCC (P<0.05); The positive detection rates of GD-EOB-DTPA and DWI were lower than those of GD-EOB-DTPA combined with DWI (P>0.05); the diagnostic AUC of GD- EOB-DTPA combined with DWI was 0.875, which was higher than that of GD-EOB-DTPA or DWI alone. 【Conclusion】 The combination of GD-EOB-DTPA contrast enhancement and DWI can effectively improve the positive detection rate of SHCC.

Key words： Carcinoma, Hepatocellular/DG Radionuclide Imaging/MT Magnetic Resonance Imaging/MT

收稿日期: 2021-04-13

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R735.7

通讯作者: *E-mail:2189001843@qq.com

引用本文:

曾飞祥, 毛思鑫, 吴伟军. Gd-EOB-DTPA对比增强与DWI两种成像方法诊断小肝细胞癌的临床价值[J]. 医学临床研究, 2021, 38(12): 1795-1797.
ZENG Fei-xiang, MAO Si-xin, WU Wei-jun. Clinical Value of GD-EOB-DTPA Contrast-enhanced Imaging and DWI in the Diagnosis of Small Hepatocellular Carcinoma. JOURNAL OF CLINICAL RESEARCH, 2021, 38(12): 1795-1797.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.12.011 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I12/1795