Gd-EOB-DTPA增强MRI及MDCT在乙型肝炎肝硬化合并小肝癌诊断中的应用

摘要/Abstract

摘要： 目的探讨特异性对比剂钆塞酸二钠(Gd-EOB-DTPA)增强磁共振成像(MRI)及多期增强多排螺旋CT(MDCT)在乙型肝炎肝硬化合并小肝癌(sHCC)中的诊断价值。方法选取2020年12月至2023年12月于解放军联勤保障部队第九〇四医院接受治疗的乙型肝炎肝硬化合并sHCC患者80例为研究对象,入院后均行Gd-EOB-DTPA-MRI和MDCT扫描,扫描间隔时间＜4周,分析2种技术对sHCC的诊断价值。结果 80例sHCC患者共检出99个病灶。Gd-EOB-DTPA-MRI检出病灶数为99个(100%)、结节体积为(3.52±0.79)cm³、典型病灶检出率为97.98%(97/99);MDCT检出病灶数为87个(87.88%)、结节体积为(2.86±0.71)cm³、典型病灶检出率为78.16%(68/87),两组之间比较差异有统计学意义(χ²=12.774,t=2.863,χ²=18.061;P<0.05)。Gd-EOB-DTPA-MRI肝胆期病灶高增强1个(1.01%)、等增强5个(5.05%)、低增强92个(92.93%);MDCT动脉期病灶高增强80个(91.95%)、等增强7个(8.05%)、低增强0个(0.00%)。Gd-EOB-DTPA-MRI检查包膜边缘无显著强化病灶17个(17.17%),低于MDCT(31个,35.63%)(χ²=8.242,P<0.05)。结论相较于MDCT,Gd-EOB-DTPA-MRI检查提高了乙型肝炎肝硬化下sHCC的检出率,具有良好的诊断价值。

关键词: 钆塞酸二钠, 磁共振成像, 多期增强多排螺旋CT, 乙型肝炎, 肝硬化, 小肝癌

Abstract: Objective To exploring the diagnostic value of specific contrast agent gadolinium oxalate disodium (Gd EOB DTPA) enhanced magnetic resonance imaging (MRI) and multi phase enhanced multi row spiral CT (MDCT) in the diagnosis of hepatitis B cirrhosis with small hepatocellular carcinoma (sHCC). Methods 80 patients with hepatitis B cirrhosis and sHCC who received treatment in The 904th Hospital of the Joint Logistics Support Force of PLA from December 2020 to December 2023 were selected as the study subjects. All patients underwent Gd-EOB-DTPA-MRI and MDCT scans after admission, with a scanning interval of less than 4 weeks, and the diagnostic value of the two techniques for sHCC was analyzed. Results A total of 99 lesions were detected in 80 sHCC patients. The number of lesions detected by Gd-EOB-DTPA-MRI was 99 (100%). The nodule volume was (3.52±0.79) cm³. The typical lesion detection rate was 97.98 (97/99). The number of lesions detected by MDCT was 87 (87.88%), the nodule volume was 2.86±0.71) cm³, and the typical lesion detection rate was 78.16 (68/87). The difference between the two groups was statistically significant (χ²=12.774, t=2.863, χ²=18.061; P<0.05). During the hepatobiliary phase of Gd-EOB-DTPA-MRI, there was 1 lesion with high enhancement (1.01%), 5 lesions with equal enhancement (5.05%), and 92 lesions with low enhancement (92.93%). During the arterial phase of MDCT, there were 80 lesions with high enhancement (91.95%), 7 lesions with equal enhancement (8.05%), and 0 lesions with low enhancement (0.00%). Gd EOB DTPA MRI examination revealed 17 lesions (17.17%) with no significant enhancement at the edge of the capsule, which was lower than MDCT (31 lesions, 35.63%) (χ²=8.242, P<0.05). Conclusion Compared with MDCT, Gd EOB DTPA-MRI improves the detection rate of sHCC in patients with hepatitis B and cirrhosis, which has good diagnostic value.

Key words: Disodium gadolinium sulfate, Magnetic resonance imaging, Multi phase enhanced multi row spiral CT, Hepatitis B, Liver cirrhosis, Small hepatocellular carcinoma

葛琦, 殷慧康, 柏玲, 叶黛西. Gd-EOB-DTPA增强MRI及MDCT在乙型肝炎肝硬化合并小肝癌诊断中的应用[J]. 肝脏, 2025, 30(8): 1104-1107.

GE Qi, YIN Hui-kang, BAI Ling, YE Dai-xi. The application of Gd-EOB-DTPA enhanced MRI and MDCT in the diagnosis of hepatitis B cirrhosis combined with small liver cancer[J]. Chinese Hepatolgy, 2025, 30(8): 1104-1107.

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