摘要
目的探讨钆塞酸二钠(gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic,Gd-EOB-DTPA,简称EOB)增强MRI多定量参数在肝胆期(hepatobiliary phase,HBP)乏血供低信号结节(hypovascular hypointense nodules,HHN)进展风险预测中的价值。方法选取在山东大学齐鲁医院经钆塞酸二钠增强MRI(EOB enhanced MRI,EOB-MRI)检查并出现肝胆期HHN的患者作为研究对象,通过随访分为稳定组与不稳定组,观察病灶基线及随访中的影像特点,在基线影像上测量并计算相关参数。比较两组HHN之间各基线定量参数的差异,受试者工作特征曲线(receiver operating characteristic curve,ROC)分析各定量参数对结节稳定性的预测效能,二元Logistic回归模型分析肝胆期HHN进展的风险因子。结果T_(2)WI信号平均值,T_(2)WI及肝胆期的对比噪声比(contrast-to-noise ratio,CNR)CNR_(T_(2)WI)、CNR_(HBP),肝胆期对比率(contrast ratio,CR)CR_(HBP),肝胆期HHN强化率在两组之间的差异均有统计学意义(P=0.045,P=0.037,P=0.043,P=0.049,P=0.003),表观弥散系数(apparent diffusion coefficient,ADC)值及CR_(ADC)在两组之间的差异均有统计学意义(P<0.001,P=0.001)。ROC曲线分析显示,肝胆期强化率、ADC值及CR_(ADC)对评价HHN稳定性具有良好的预测效能,敏感度分别为72.2%、96.9%、87.5%,特异性分别为72.7%、54.5%、63.6%。扩散加权成像(diffusion weighted imaging,DWI)高信号、肝胆期强化率是肝胆期HHN进展的预测因子。结论EOB增强MRI多定量参数的肝胆期强化率、ADC值及CR_(ADC)有助于对肝胆期HHN进行危险度分层。
Objective To explore the value of multiple quantitative parameters of gadoxetic acid(gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic(Gd-EOB-DTPA,abbreviated as EOB)enhanced MRI in predicting the risk of progression of hypovascular hypointense nodules(HHN)in hepatobiliary phase(HBP).Methods Patients with HHNs in hepatobiliary phase examined by EOB enhanced MRI(EOB-MRI)in Qilu Hospital of Shandong University were divided into stable group and unstable group through follow-up.The baseline and imaging characteristics of the lesions were observed,and some parameters were measured and calculated.The differences of baseline quantitative parameters between the two groups of HHN were compared.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency of each quantitative parameter on nodular stability.Binary Logistic regression was used to analyze the risk factors for the progression of HHN in hepatobiliary phase.Results There were significant differences in the mean value of T_(2)WI signal,contrast-to-noise ratio(CNR)at T_(2)WI and hepatobiliary phase(CNR_(T_(2)WI),CNR_(HBP)),contrast ratio at hepatobiliary phase(CR_(HBP))and hepatobiliary phase enhancement rate between the two groups(P=0.045,P=0.037,P=0.043,P=0.049,P=0.003).There were significant differences in apparent diffusion coefficient(ADC)value and CR_(ADC) between the two groups(P<0.001,P=0.001).ROC curve analysis showed that hepatobiliary phase enhancement rate,ADC value and CR_(ADC) had good predictive power for evaluating HHN stability,with sensitivities of 72.2%,96.9%,87.5%and specificities of 72.7%,54.5%and 63.6%,respectively.High signal intensity on diffusion-weighted imaging(DWI)and the enhancement rate of HHN in hepatobiliary phase were predictors of the progression of HHN in hepatobiliary phase.Conclusion The hepatobiliary phase enhancement rate,ADC value and CR_(ADC) of EOB-MRI multi-quantitative parameters are helpful for the risk stratification of HHN in hepatobiliary phase.
作者
刘小文
曹永泉
侯明源
于德新
LIU Xiaowen;CAO Yongquan;HOU Mingyuan;YU Dexin(Department of Radiology,Qilu Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250012,Shandong,China;Department of Radiology,Endocrine and Metabolic Diseases Hospital of Shandong First Medical University,Jinan 250000,Shandong,China;Department of Radiololgy,Zibo First Hospital,Zibo 255299,Shandong,China;Department of Radiololgy,Maternal and Child Health Hospital of Weihai,Weihai 264299,Shandong,China)
出处
《山东大学学报（医学版）》
CAS
北大核心
2024年第4期31-39,共9页
Journal of Shandong University:Health Sciences
关键词
肝胆期乏血供低信号结节
钆塞酸二钠
磁共振成像
定量参数
Hypovascular hypointense nodules in hepatobiliary phase
Gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic
Magnetic resonance imaging
Quantitative parameter
