MRI与超声造影在肝细胞癌与血管瘤鉴别诊断中的应用

摘要/Abstract

摘要： 目的探讨磁共振扩散加权成像与超声造影在肝细胞癌与血管瘤的诊断鉴别中的应用价值。方法选取2018年1月至2020年5月86例肝脏实质性占位病变患者的临床资料进行回顾性分析,经病理检查确诊为肝细胞癌46例,肝血管瘤40例。观察肝细胞癌与血管瘤的超声造影参数(开始增强时间、峰值时间、消退时间)与MRI参数(ADC、PF);评估开始增强时间、峰值时间、消退时间、ADC、PF诊断鉴别肝细胞癌与血管瘤的AUC、敏感度、特异度及约登指数。结果肝细胞癌患者的开始增强时间、峰值时间、消退时间、ADC、PF分别为(10.34±1.89)s、(22.98±8.32)s、(36.85±12.32)s、(1.37±0.32)×10^-3 s/mm²、PF(23.25±3.32)%,低于肝血管瘤患者(14.59±4.25)s、(35.06±10.65)s、(52.05±15.75)s、(2.18±0.65)×10^-3 s/mm²、PF(30.18±5.98)%,差异有统计学意义(P<0.05)。ROC曲线分析显示,开始增强时间、峰值时间、消退时间、ADC、PF诊断鉴别肝细胞癌与血管瘤的AUC分别为0.746、0.786、0.747、0.828、0.833(P<0.05);敏感度分别为100.00%、100.00%、95.70%、58.70%、71.70%;特异度分别为50.00%、47.50%、50.00%、92.50%、85.00%。结论磁共振扩散加权成像与超声造影均能为肝细胞癌与血管瘤的诊断鉴别提供参考信息,但MRI的应用价值更高。

关键词: MRI, 超声造影, 肝细胞性肝癌, 血管瘤

Abstract: Objective To explore the practical utility of magnetic resonance diffusion-weighted imaging and contrast-enhanced ultrasound in the diagnosis and differentiation of hepatocellular carcinoma and hemangioma. Methods We retrospectively analyzed the clinical data of 86 patients with substantial hepatic space-occupying lesions from January 2018 to May 2020. Pathological examination confirmed 46 cases of hepatocellular carcinoma and 40 cases of hepatic hemangioma. MRI and contrast-enhanced ultrasound examinations were conducted to observe the imaging appearances of hepatocellular carcinoma and hemangioma. Additionally, contrast-enhanced ultrasound parameters (start time, peak time, and regression time) and MRI parameters (ADC, PF) of hepatocellular carcinoma and hemangioma were evaluated. The start of enhancement time, peak time, regression time, ADC, PF AUC, sensitivity, specificity, and Youden index were assessed for the diagnosis of hepatocellular carcinoma and hemangioma. Results The start time, peak time, regression time, ADC and PF of hepatocellular carcinoma patients were (10.34±1.89) s, (22.98±8.32) s, (36.85±12.32) s, (1.37±0.32) ×10^-3 s/mm², and (23.25±3.32) %, respectively. The initial enhancement time, peak time, regression time, ADC, PF were (14.59±4.25) s, (35.06±10.65) s, (52.05±15.75) s, (2.18±0.65) ×10^-3 s/mm², (30.18±5.98) %, respectively. The differences were statistically significant (P<0.05). Analysis of the ROC curve showed that the AUCs of start time, peak time, regression time, ADC, and PF in the diagnosis and differentiation of hepatocellular carcinoma and hemangioma were 0.746, 0.786, 0.747, 0.828, 0.833, P<0.05. The sensitivity was 100.00%, 100.00%, 95.70%, 58.70%, 71.70%, respectively. The specificity was 50.00%, 47.50%, 50.00%, 92.50% and 85.00%, respectively. Conclusion Both magnetic resonance diffusion-weighted imaging and contrast-enhanced ultrasound can provide reference information for the diagnosis and distinguishing between hepatocellular carcinoma and hemangioma. However, MRI is considered to be more applicable in this regard.

Key words: magnetic resonance diffusion-weighted imaging, contrast-enhanced ultrasound, hepatocellular carcinoma, hemangioma

解玉文, 张全禄, 王萍萍. MRI与超声造影在肝细胞癌与血管瘤鉴别诊断中的应用[J]. 肝脏, 2023, 28(10): 1195-1198.

XIE Yu-wen¹, ZHANG Quan-lu¹, WANG Ping-ping². Application of MRI and contrast ultrasound in the diagnosis and differentiation of hepatocellular carcinoma and hemangioma[J]. Chinese Hepatolgy, 2023, 28(10): 1195-1198.

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