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肝臟特異性增強MRI檢查的臨床價值評估
Clinical value of liver-specific contrast-enhanced MRI
摘要
目的：通過對肝臟特異性增強MRI檢查（Gd-EOB-DTPA），常規增強CT檢查，常規超聲檢查的比較，評估肝臟特異性增強MRI檢查的臨床應用價值。方法：回顧性分析了11例經手術、穿刺活檢或臨床證實的肝臟佔位性病變的影像學徵象，均同時行肝臟超聲檢查、常規增強CT和特異性增強MRI檢查。結果：1.11例病例中原發性肝癌（HCC）4例，轉移瘤2例，局灶性結節增生（FNH）2例，血管瘤3例。2.所有病灶共約32個，良性病灶12個，惡性病灶20個。特異性增強MRI動態掃描敏感性為90%，實質期敏感性為85%，動態掃描結合實質期敏感性為95%；常規增強CT的敏感性為90%；常規超聲的敏感性為55%；特異性增強MRI動態掃描與常規CT增強掃描的敏感性比較無顯著差異（P>0.05），但與常規超聲檢查方法的敏感性比較均具有顯著差異（P<0.05）。3.特異性增強MRI檢查（動態＋實質期）特異性達100%，常規增強CT檢查的特異性為66.7%，常規超聲檢查的特異性為50%；三種檢查方法的特異性具有顯著差異（P<0.05）。結論：肝臟特異性增強MRI檢查（動態＋實質期）可以提高肝臟局灶性病灶的檢出率和定性診斷的準確率。
並列摘要
Objective: To evaluate the clinical value of liver-specific contrast -enhanced MRI by comparing liver-specific contrast MRI (GD-EOB-DTPA) with contrast CT and ultrasonography in the detection of liver lesions. Methods: Eleven patients with either surgically, biopsy or clinical proven liver occupying lesion underwent liver sonography, contrast CT and liver-specific contrast MRI. Retrospectively analysed the characteristics of the liver lesions among these three examinations. Results: 1. Four of the 11 patients were HCC, 2 patients were liver metastases, 2 patients were FNH, 3 patients were Hemangiomas. 2. A total of 32 liver lesions were found in 11 patients and 20 lesions were malignancy and 12 lesions were benign. Sensitivity of liver-specific dynamic contrast MRI was 90%,sensitivity of hepatocyte phase was 85%. Combining dynamic scan with hepatocyte phase, sensitivity was 95%. Sensitivity of contrast CT was 90%. Sensitivity of sonography was 55% . There were no significant differences among first two examinations(P>0.05) ,but there were significant differences compared with ultrasonic (P<0.05). 3. 32 lesions detected by combining dynamic scan with hepatocyte phase of liver-specific dynamic contrast MRI, specificity was 100% , specificity of contrast CT was 66.7% , specificity of sonography was 50% . There were significant differences among these three examinations (P<0.05). Conclusion: Combining dynamic scan with hepatocyte phase of liver-specific contrast MRI significantly improved the detection of hepatic lesions, as well as improved the diagnostic accuracy in differentiating between benign and malignant lesions.