增强MRI与增强CT鉴别诊断肝脏局灶性病变性质价值研究*

doi:10.3969/j.issn.1672-5069.2025.06.027

摘要/Abstract

摘要： 目的本研究旨在评估增强MRI与增强CT鉴别诊断肝脏局灶性病变(FLL)良恶性的价值。方法 2022年1月～2024年12月江苏省宿迁市第一人民医院诊治的96例FLL患者,均接受增强CT和MRI检查,经穿刺活检和术后组织病理学检查诊断。结果经组织病理学检查,本组诊断良性病变46例和恶性病变50例;MRI提示恶性病变直径为(3.3±1.6)cm,显著大于良性病变【(2.6±1.2)cm,P<0.05】;恶性病变出现坏死囊变、环形强化和肝胆期病灶呈低信号占比分别为84.0%、58.0%和100.0%,均显著高于良性病变(分别为26.1%、0.0%和32.6%,P<0.05);CT扫描显示恶性肿瘤边缘模糊、坏死囊变、环形强化和增强扫描呈快进快出占比分别为80.0%、88.0%、56.0%和80.0%,均显著高于良性病变(分别为6.5%、32.6%、8.7%和0.0%,P<0.05);增强CT联合MRI诊断肝脏占位性病变的AUC为0.969(95%CI:0.933～1.000),其敏感度为98.0%,特异度为91.3%,显著优于单一检查诊断(P<0.05)。结论增强MRI和CT扫描均能够有效鉴别FLL性质,帮助临床医生做出合理的判断,以便于及时、正确的处理。

关键词: 肝脏局灶性病变, 磁共振成像, 计算机断层扫描, 诊断

Abstract: Objective This study aimed to investigate qualitative diagnosis of focal liver lesions (FLL) by enhanced magnetic resonance imaging (MRI) and enhanced CT. Methods A retrospective analysis was conducted on 96 patients with FLL who admitted to the First People's Hospital of Suqian, Jiangsu Province between January 2022 and December 2024. The final diagnosis was made by histo-pathological examination. All patients underwent MR and CT scan. Results Histo-pathological examination proven benign intrahepatic lesions in 46 cases and malignant ones in 50 cases; MRI found the malignant lesions with diameter of (3.3±1.6)cm, much greater than [(2.6±1.2)cm, P<0.05] in benign ones; percentages of cystic necrosis, circular enhancement and low signal at hepatobiliary phase in malignant lesions were 84.0%, 58.0% and 100.0%, all much higher than 26.1%, 0.0% and 32.6% (P<0.05), respectively, in benign lesions; CT scan demonstrated that percentages of blurred margins, cystic necrosis, circular enhancement and “fast in and fast out” model at enhanced scan in malignant lesions were 80.0%, 88.0%, 56.0% and 80.0%, all significantly higher than 6.5%, 32.6%, 8.7% and 0.0% (P<0.05), respectively, in benign lesions; the AUC was 0.969(95%CI:0.933-1.000), with sensitivity of 98.0% and specificity of 91.3%, when enhanced MRI and CT was combined to made diagnosis, much superior to MR or CT alone (P<0.05). Conclusion Both enhanced MRI and CT are useful tools for differentiating benign and malignant intrahepatic lesions, which might help clinicians make decisions as early as possible.

Key words: Hepatoma, Focal liver lesions, MRI, CT, Diagnosis

陈敏, 张畅. 增强MRI与增强CT鉴别诊断肝脏局灶性病变性质价值研究^*[J]. 实用肝脏病杂志, 2025, 28(6): 906-909.

Chen Min, Zhang Chang. Qualitative diagnosis of focal liver lesions by enhanced MRI and CT: Analysis of 96 cases[J]. Journal of Practical Hepatology, 2025, 28(6): 906-909.

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增强MRI与增强CT鉴别诊断肝脏局灶性病变性质价值研究^*

Qualitative diagnosis of focal liver lesions by enhanced MRI and CT: Analysis of 96 cases

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