钆塞酸二钠增强磁共振扫描诊断肝脏局灶性病变研究*

doi:10.3969/j.issn.1672-5069.2019.04.032

实用肝脏病杂志 ›› 2019, Vol. 22 ›› Issue (4): 577-580.doi: 10.3969/j.issn.1672-5069.2019.04.032

钆塞酸二钠增强磁共振扫描诊断肝脏局灶性病变研究^*

杨富存, 尚怀学, 盖永浩

276001山东省临沂市肿瘤医院检验科（杨富存,尚怀学）;
山东省省立医院影像科（盖永浩）

收稿日期:2018-12-19 出版日期:2019-07-10 发布日期:2019-07-19
通讯作者: 尚怀学,E-mail:shanghuaixue@163.com
作者简介:杨富存,男,50岁,大学本科,主管技师。E-mail:yangfucun1221@163.com
基金资助:
*山东省自然科学基金资助项目（编号:ZR2012CM0165）

Enhanced magnetic resonance imaging by gadolinium disodium sebacate in diagnosis of patients with focal liver lesions

Yang Fucun, Shang Huaixue, Gai Yonghao

Clinical Laboratory,Linyi Tumor Hospital,Linyi 276001,Shandong Province,China

Received:2018-12-19 Online:2019-07-10 Published:2019-07-19

摘要/Abstract

摘要： 目的通过与手术后组织病理学诊断结果比较,观察钆塞酸二钠（Gd-EOB-DTPA）增强磁共振成像（MRI）对肝脏局灶性病变（FLL）的诊断价值。方法我院收治的FLL患者68例,接受Gd-EOB-DTPA增强MRI检查,与术后组织病理学诊断比较检查结果的正确性。结果 68例FLL患者经术后组织病理学检查诊断为肝细胞癌36例,肝内胆管细胞癌6例,混合型肝癌8例,肝局灶性结节性增生12例,肝血管平滑肌脂肪瘤4例,非FLL 2例,而Gd-EOB-DTPA增强MRI诊断FLL 64例,其中肝细胞癌37例,肝内胆管细胞癌7例,混合型肝癌4例,肝局灶性结节性增生14例,肝血管平滑肌脂肪瘤2例,非FLL 4例。增强MRI诊断FLL的Kappa值为0.7,其灵敏度为97.1%,特异度为100.0%,阳性预测值为100.0%,阴性预测值为50.0%。结论采取Gd-EOB-DTPA增强MRI检查对FLL诊断具有较高的灵敏度和特异度,临床应重视其诊断价值。

关键词: 肝脏局灶性病变, 肝细胞癌, 磁共振成像, 钆塞酸二钠增强, 诊断

Abstract: Objective This study was aimed to investigate the enhanced magnetic resonance imaging(MRI) by gadolinium disodium sebacate （Gd-EOB-DTPA） in diagnosis of patients with focal liver lesions （FLL）.Methods A prospective study was conducted on 68 patients with suspected FLL by ultrasound and/or CT scan,and all the patients accepted Gd-EOB-DTPA enhanced MRI scan. The diagnosis of MRI was reevaluated by post-operational histopathological examination.Results The liver histopathological examination showed that hepatocullular carcinoma（HCC） in 36,intrahepatic cholangiocarcinoma in 6,mixed liver carcinoma in 8,hepatic focal nodular hyperplasia in 12,hepatic vascular leiomyolipoma in 4 and non-FLL in 2,while the enhanced MRI demonstrated that HCC in 37,intrahepatic cholangiocarcinoma in 7,mixed liver carcinoma in 4,hepatic focal nodular hyperplasia in 14,hepatic vascular leiomyolipoma in 2 and non-FLL in 4;the Kappa was 0.7 when the FLLs were diagnosed by MRI,with the sensitivity of 97.1%,specificity of 100.0%,positive predicting value of 100.0% and negative predicting value of 50.0%. Conclusion The application of MRI intensified by Gd-EOB-DTPA enhancement might be helpful in diagnosis of patients with FLL,which needs further validation in clinical practice.

Key words: Focal liver lesions, Hepatoma, Magnetic resonance imaging, Gadolinium disodium sebacate, Diagnosis

杨富存, 尚怀学, 盖永浩. 钆塞酸二钠增强磁共振扫描诊断肝脏局灶性病变研究^*[J]. 实用肝脏病杂志, 2019, 22(4): 577-580.

Yang Fucun, Shang Huaixue, Gai Yonghao. Enhanced magnetic resonance imaging by gadolinium disodium sebacate in diagnosis of patients with focal liver lesions[J]. Journal of Practical Hepatology, 2019, 22(4): 577-580.

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钆塞酸二钠增强磁共振扫描诊断肝脏局灶性病变研究^*

Enhanced magnetic resonance imaging by gadolinium disodium sebacate in diagnosis of patients with focal liver lesions

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