摘要
目的探讨多参数磁共振成像(Mp-MRI)联合肝脏影像报告和数据管理系统(LI-RADS)分级在小肝癌(SHCC)中的诊断价值,以期为临床早期定性诊断、病情控制提供依据。方法选取2016年6月—2019年4月病灶直径≤3 cm的肝脏局灶性病变128例作为研究对象,均行Mp-MRI检查。以病理检查诊断为金标准,评价Mp-MRI、LI-RADS分级单独及联合诊断SHCC的价值。结果LI-RADS分级显示,128例中21例为LR-1,12例为LR-2,16例为LR-3,31例为LR-4,48例为LR-5;以病理检查结果为金标准,SHCC患者增强率(ER)、表观扩散系数(ADC)、最大上升斜率(MSI)、平均强化时间(MET)低于非SHCC患者,脂肪分数(FF)、最大下降斜率(MSD)高于非SHCC患者(P<0.01);Spearman相关性分析显示,ER、ADC、MSI、MET与LI-RADS分级呈负相关(r=-0.497、-0.541、-0.419、-0.528,P<0.01),FF、MSD与LI-RADS分级呈正相关(r=0.506、0.435,P<0.01)。ER、FF、ADC、MSD、MSI、MET、LI-RADS分级诊断SHCC的曲线下面积(AUC)分别为0.764、0.753、0.756、0.804、0.817、0.813、0.844,联合诊断的AUC为0.926(95%CI:0.866,0.964)。结论Mp-MRI、LI-RADS分级对于SHCC均具有一定的诊断价值,临床可通过二者联合应用进行早期筛查诊断,以制定相应干预方案,改善患者预后。
Objective To investigate the diagnostic value of multi-parameter magnetic resonance imaging(Mp-MRI)combined with liver Imaging Reporting and Data Management System(LI-RADS)grading in small hepatocellular carcinoma(SHCC),in order to provide evidence for early clinical qualitative diagnosis and disease control.Methods A total of 128 patients with focal liver lesions≤3 cm in diameter from June 2016 to April 2019 were selected as research subjects,all of whom underwent Mp-MRI examination.With pathological diagnosis as the gold standard,the value of Mp-MRI and LI-RADS grading alone and in combination in the diagnosis of SHCC was evaluated.Results The LI-RADS grading showed that among 128 cases,21 cases were LR-1,12 cases were LR-2,16 cases were LR-3,31 cases were LR-4,and 48 cases were LR-5.With pathological results as the gold standard,enhancement rate(ER),apparent diffusion coefficient(ADC),maximum slope of increase(MSI)and mean time to enhance(MTE)in SHCC patients were lower than those in non-SHCC patients,and fat fraction(FF)and maximum slope of decrease(MSD)were higher than those in non-SHCC patients(P<0.01).Spearman correlation analysis showed that Mp-MRI parameters ER,ADC,MSI,and MET were negatively correlated with LI-RADS grading(r=-0.497,-0.541,-0.419,-0.528,P<0.01).FF and MSD were positively correlated with LI-RADS grading(r=0.506,0.435,P<0.01).The area under the receiver operating characteristic(ROC)curve(AUC)of ER,FF,ADC,MSD,MSI,MET,and LI-RADS grading for the diagnosis of SHCC was 0.764,0.753,0.756,0.804,0.817,0.813,and 0.844,respectively.The AUC for combined diagnosis was 0.926(95%CI:0.866,0.964).Conclusion Mp-MRI and LI-RADS grading have certain diagnostic value for SHCC,and they can be used in combination for early screening and diagnosis,so as to formulate corresponding intervention programs and improve the prognosis of patients.
作者
崔潇
崔冰
CUI Xiao;CUI Bing(Department of Radiology,the First Hospital of Handan City,Handan,Hebei 056002,China;Department of Clinical Laboratory,the First Hospital of Handan City,Handan,Hebei 056002,China)
出处
《临床误诊误治》
CAS
2022年第11期54-58,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省卫生健康委科研基金项目(20200438)。
关键词
肝癌
多参数磁共振成像
肝脏影像报告和数据管理系统
表观扩散系数
平均强化时间
诊断价值
Liver cancer
Multi-parameter magnetic resonance imaging
Liver imaging reporting and data management system
Apparent diffusion coefficient
Average strengthening time
Diagnostic value
