MRI联合DWI和DCE序列对脂肪肝背景下局灶结节性

doi:10.3969/j.issn.1671-7171.2023.01.013

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摘要 【目的】 探讨核磁共振弥散加权成像(MRI-DWI)、动态增强磁共振成像(DCE-MRI)序列对脂肪肝背景下局灶结节性病变的诊断价值。【方法】 前瞻性选取2019年4月至2021年10月靖边县人民医院收治的118例脂肪肝合并局灶结节性病变患者,所有患者均行MRI-DWI、DCE-MRI检查,以病理诊断结果作为金标准。分析不同局灶结节性病变患者表观扩散系数(ADC)值,对比不同局灶结节性病变患者DCE-MRI扫描参数,分析不同局灶结节性病变患者时间-信号曲线类型,分析MRI-DWI、DCE-MRI诊断效能及一致性。【结果】 51例为恶性结节,67例患者为良性结节。恶性结节组不同b值的ADC值均低于良性结节组(P<0.05)。恶性结节组的峰值(PV)、最大上升斜率(MSI)、最大下降斜率(MSD)均低于对照组(P<0.05),恶性结节组的K_ep值、K_trans值、V_e均高于对照组(P<0.05)。恶性结节组、良性结节组的时间-信号曲线类型比较,差异有统计学意义(P<0.05)。MRI-DWI、DCE-MRI及二者联合诊断诊断脂肪肝背景下局灶结节性病变的灵敏度分别为94.12%、96.08%、94.12%,特异度分别为91.04%、89.55%、100.00%。脂肪肝背景下局灶结节性病变患者病理诊断与MRI-DWI、DCE-MRI、MRI-DWI＋DCE-MRI诊断的一致性Kappa值分别为0.808、0.815、0.824。【结论】 脂肪肝背景下局灶结节性病变患者的MRI-DWI序列、DCE-MRI扫描参数与病灶性质有关,MRI联合DWI和DCE序列可提高脂肪肝背景下局灶结节性病变的诊断效能。

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	袁海军
	曾茗

关键词 ：脂肪肝/影像诊断, 磁共振成像, 弥散磁共振成像

Abstract：【Objective】 To explore the diagnostic value of MRI diffusion weighted imaging (MRI-DWI) and dynamic enhanced magnetic resonance imaging (DCE-MRI) sequences for focal nodular lesions under the background of fatty liver. 【Methods】 A total of 118 patients with fatty liver complicated with focal nodular lesions who were admitted to our hospital from April 2019 to October 2021 were selected as the research objects. All patients underwent MRI-DWI and DCE-MRI examinations. The pathological diagnosis was considered as the gold standard for diagnosis. The apparent diffusion coefficient (ADC) values of patients with different focal nodular lesions were analyzed. The DCE-MRI scan parameters of patients with different focal nodular lesions were compared. The time-signal curve types of patients with different focal nodular lesions were analyzed as well. The diagnostic efficiency and consistency of MRI-DWI and DCE-MRI were analyzed. 【Results】 There were 51 cases of malignant nodules and 67 cases of benign nodules in 118 patients. The ADC scores of different b values in the malignant nodule group were lower than those in the benign nodule group (P<0.05). The peak value (PV), maximum ascending slope (MSI), and maximum descending slope (MSD) of the malignant nodule group were lower than those of the control group (P<0.05), while the K_ep, K_trans and V_e values of the malignant nodule group were higher than those of the control group (P<0.05). When types of the time-signal curve were compared between the malignant nodule group and the benign nodule group, the difference was statistically significant (P<0.05). The sensitivities of MRI-DWI, DCE-MRI and their combination measurement for diagnosis of focal nodular lesions in the context of fatty liver were 94.12%, 96.08% and 94.12%, respectively; While the specificities of them were 91.04%, 89.55%, and 100.00%, respectively. The consistent Kappa values of pathological diagnosis with MRI-DWI, DCE-MRI or MRI-DWI+MRI diagnosis of focal nodular lesions in patients with fatty liver were 0.808, 0.815, 0.824, respectively. 【Conclusion】 The parameters of MRI-DWI and DCE-MRI in patients with focal nodular lesions under the background of fatty liver are related to the nature of the lesions. MRI combined with DWI and DCE sequences can improve the diagnostic efficiency of focal nodular lesions in the background of fatty liver.

Key words： Fatty Liver/DG Magnetic Resonance Imaging Diffusion Magnetic Resonance Imaging

收稿日期: 2022-08-26

中图分类号:

R575.5

通讯作者: *,E-mail:244980141@qq.com

引用本文:

袁海军, 曾茗. MRI联合DWI和DCE序列对脂肪肝背景下局灶结节性[J]. 医学临床研究, 2023, 40(1): 41-44.
YUAN Hai-jun, ZENG Ming. Analysis of MRI-DWI and DCE-MRI Sequence in the Diagnosis of Focal Nodular Lesions under the Background of Fatty Liver. JOURNAL OF CLINICAL RESEARCH, 2023, 40(1): 41-44.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.01.013 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I1/41

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