gd-eob-dtpa肝胆期mri结合dwi对原发性肝细胞癌的检出价值

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1、DOI：10.16016/j.1000-5404.2014122012201Gd-EOB-DTPA肝胆期MRI结合DWI对原发性肝细胞癌的检出价值武靖，康钰，洪楠，李安琪，王屹（100044北京，北京大学人民医院放射科）[摘要]目的在常规动态对比增强MRI的基础上，探讨Gd-EOB-DTPA增强MR扫描肝胆期结合扩散加权成像序列（DW-MRI）诊断原发性肝细胞癌的价值。方法回顾性分析60例怀疑原发性肝细胞癌（hepatocellularcarcinoma，HCC）患者的Gd-EOB-DTPA增强MR扫描动脉期、门脉期、肝胆期及DWI图像资料。分为3组进行阅读和比较，分析影像特

2、征，获得最终影像诊断结果。以手术病理为标准，采用受试者工作特征曲线（ROC）曲线下面积（AUC）分析Gd-EOB-DTPA肝胆期结合DWI序列对HCC的诊断价值。结果60例患者共发现肝内病灶80个，其中40例患者共诊断56个HCC，其中22个直径≤2cm。在常规动态对比增强MR扫描基础上，结合Gd-EOB-DTPA肝胆期及DW－MRI不能增加对所有大小的HCC的诊断准确性，但对直径≤2cm的早期HCC的准确性最高（P=0.0248），且当仅结合Gd-EOB-DTPA增强MR扫描肝胆期时，其诊断准确性亦高于常规对比动态增强扫描（P=0.0432），具统计学意义。结论在常规动态对

3、比增强MR基础上，结合Gd-EOB-DTPA增强肝胆期图像和DWI序列有助于诊断直径≤2cm的早期HCC，可以作为常规MR序列的有效补充。[关键词]Gd-EOB-DTPA；扩散加权成像；肝细胞癌[中图法分类号][文献标志码]AEvaluatingthediagnosticaccuracyofGd-EOB-DTPA-enhancedHepatobiliaryphaseMRIimagingandCombinedwithDW-MRIinhepatocellularcarcinomaWuJing，KangYu，HongNan，LiAnqi，WangYi(DepartmentofRad

4、iology，PekingUniversityPeople’sHospital,Beijing100044,China)[Abstract]Objective:ToinvestigateGd-EOB-DTPA-enhancedhepatobiliaryphaseMRimagingandcombinedwithdiffusion-weightedMRimaging(DW-MRI)indetectinghepatocellularcarcinoma(HCC)withhistopathologyasreferencestandard.Methods:FollowedIRB,aret

5、rospectivereviewidentifiedsixtypatientswhoweresuspectedwithHCCunderwentGd-EOB-DTPA–enhancedarterialphase(HAP),portalvenousphase(PVP),hepatobiliaryphase(HP)MRandDWMRIbeforesurgeryandhistopathologicalbiopsy.Threeimagegroupswereassignedandcompared.TworadiologistsgradedlikelihoodofHCCwithafive-

6、pointconfidencescale.TheaccuracyofMRimagingprotocolsindetectingHCCwasanalyzedbytheReceiveroperatingcharacteristic(ROC)withthehistopathologyasreferencestandard.Results:Basedonthehistopathologicalanalyses,56HCCsweredemonstratedinthisstudyand22HCCslessthan2cmindiameterswereobserved.Combinedwit

7、hGd-EOB-DTPA-enhancedhepabiliaryphaseMRIandDWIshowedgreatestabilityinidentificationofHCC(≤2cm)comparedwithconventionaldynamicenhancedMRIwasseen(P=0.0248).TheaccuracyofaddingGd-EOB-DTPA-enhancedhepabiliaryphaseMRIindiagnosisofHCC(≤2cm)wasgreaterthanconven