DOI10.16016j.1000-5404.2014122012201Gd-EOB-DTPA肝胆期.doc

DOI：10.16016/j.1000-5404.2014122012201 Gd-EOB-DTPA肝胆期MRI结合DWI对原发性肝细胞癌的检出价值 武 靖，康 钰，洪 楠，李安琪，王 屹（100044 北京，北京大学人民医院放射科） [摘要] 目的 在常规动态对比增强MRI的基础上，探讨Gd-EOB-DTPA增强MR扫描肝胆期结合扩散加权成像序列（DW-MRI）诊断原发性肝细胞癌的价值。方法 回顾性分析60例怀疑原发性肝细胞癌（hepatocellular carcinoma，HCC）患者的Gd-EOB-DTPA增强MR扫描动脉期、门脉期、肝胆期及DWI图像资料。分为3组进行阅读和比较，分析影像特征，获得最终影像诊断结果。以手术病理为标准，采用受试者工作特征曲线（ROC）曲线下面积（AUC）分析Gd-EOB-DTPA肝胆期结合DWI序列对HCC的诊断价值。结果 60例患者共发现肝内病灶80个，其中40例患者共诊断56个HCC，其中22个直径≤2 cm。在常规动态对比增强MR扫描基础上，结合Gd-EOB-DTPA肝胆期及DW－MRI不能增加对所有大小的HCC的诊断准确性，但对直径≤2 cm的早期HCC的准确性最高（P=0.0248），且当仅结合Gd-EOB-DTPA增强MR扫描肝胆期时，其诊断准确性亦高于常规对比动态增强扫描（P=0.0432），具统计学意义。结论 在常规动态对比增强MR基础上，结合Gd-EOB-DTPA增强肝胆期图像和DWI序列有助于诊断直径≤2 cm的早期HCC，可以作为常规MR序列的有效补充。 [关键词] Gd-EOB-DTPA；扩散加权成像；肝细胞癌 [中图法分类号] [文献标志码] A Evaluating the diagnostic accuracy of Gd-EOB-DTPA-enhanced Hepatobiliary phase MRI imaging and Combined with DW- MRI in hepatocellular carcinoma Wu Jing，Kang Yu，Hong Nan，Li Anqi，Wang Yi (Department of RadiologyPeking University People’s Hospital, Beijing 100044, China) [Abstract] Objective: To investigate Gd-EOB-DTPA- enhanced hepatobiliary phase MR imaging and combined with diffusion-weighted MR imaging (DW-MRI) in detecting hepatocellular carcinoma (HCC) with histopathology as reference standard. Methods: Followed IRB, a retrospective review identified sixty patients who were suspected with HCC underwent Gd-EOB-DTPA–enhanced arterial phase (HAP), portal venous phase (PVP) , hepatobiliary phase (HP) MR and DW MRI before surgery and histopathological biopsy. Three image groups were assigned and compared. Two radiologists graded likelihood of HCC with a five-point confidence scale. The accuracy of MR imaging protocols in detecting HCC was analyzed by the Receiver operating characteristic (ROC) with the histopathology as reference standard. Results:Based on the histopathological analyses, 56 HCCs were demonstrated in this study and 22 HCCs less than 2cm in diameters were observed. Combined with Gd-EOB-DTPA-enhanced hepabiliary pha