MRI多b值成像联合64排螺旋CT在乙型肝炎肝硬化患者肝脏再生结节诊断中的价值

摘要/Abstract

摘要： 目的分析磁共振成像(MRI)多b值成像联合64排螺旋计算机断层扫描(CT)在乙型肝炎肝硬化患者肝脏再生结节诊断中的价值。方法将2020年3月—2022年7月南通市第二人民医院收治的69例乙型肝炎肝硬化占位性病变患者的临床资料进行回顾性分析,以病理诊断结果分成对照组(n=24,肝脏癌变结节)与研究组(n=45,肝脏再生结节)。所有患者均接受MRI多b值成像检查、64排螺旋CT检查,对比两组患者一般资料,对比两组患者门静脉、主动脉不同期扫描的CT值,对比两组患者肝实质不同期扫描的CT值,以病理诊断为金标准,分析64排螺旋CT检查及MRI多b值成像检查与病理诊断结果间的一致性,制作受试者工作特征曲线(ROC),采用曲线下面积(AUC)评价MRI多b值成像检查、64排螺旋CT检查及二者联合对乙型肝炎肝硬化患者肝脏再生结节的诊断价值。结果病理结果显示,对照组中共检出37个癌变结节,研究组中共检出98个再生结节。两组性别、年龄、肝硬化朔伊尔分期及结节直径对比无显著差异(P>0.05)。研究组门静脉的延迟期、动脉期扫描的CT值比对照组高(P<0.05)。研究组主动脉的门脉期、动脉期扫描的CT值比对照组高(P<0.05)。研究组肝实质的动脉期、门脉期及延迟期扫描的CT值高于对照组(P<0.05)。MRI多b值成像检查、64排螺旋CT检查及二者联合诊断乙型肝炎肝硬化患者肝脏再生结节与病理诊断的Kappa值分别为0.821、0.758、0.897,具有较好的一致性(P<0.05)。ROC曲线结果显示,MRI多b值成像检查、64排螺旋CT检查及二者联合诊断乙型肝炎肝硬化患者肝脏再生结节的AUC值分别为0.792、0.739、0.942(P<0.05)。结论 MRI多b值成像联合64排螺旋CT在诊断乙型肝炎肝硬化患者肝脏再生结节价值更高。

关键词: 磁共振成像多b值成像, 64排螺旋计算机断层扫描, 乙型肝炎肝硬化, 肝脏再生结节, 诊断价值

Abstract: Objective To analyze the value of magnetic resonance imaging (MRI) combined with 64-slice spiral computed tomography (CT) in the diagnosis of liver regenerating nodules in hepatitis B-related cirrhotic patients. Methods The clinical data of 69 patients with space occupying liver lesions and hepatitis B-related cirrhosis admitted from March 2020 to July 2022 were retrospectively analyzed. They were divided into a control group (n=24, with cancerous nodules in liver) and a study group (n=45, with regenerative nodules in liver) according to pathological diagnosis. All patients received MRI multi-B value imaging examination and 64-slice spiral CT examination. General data, CT values of portal vein and aorta scanning in different periods, and CT values of hepatic parenchyma scanning in different periods were compared between the two groups. The pathological diagnosis was taken as the gold standard. The consistency of 64-slice spiral CT, MRI multi-B-value imaging, and pathological diagnosis results was analyzed. Receiver operating characteristic curve (ROC) was made while the area under the curve (AUC) was used to evaluate the diagnostic value of MRI multi-B-value imaging, 64-slice spiral CT and their combination in liver regenerating nodules in patients with hepatitis B-related cirrhosis. Results The pathological results showed that there were 37 cancerous nodules detected in the control group and 98 regenerated nodules detected in the study group. There were no differences in the sex, age, Scheuer stage of cirrhosis and nodule diameter between the two groups (P>0.05). The delayed phase and arterial phase of portal vein, the portal phase and arterial phase of aorta, the arterial phase, portal phase and delayed phase of hepatic parenchyma of CT values in the study group were higher than those of the control group (P<0.05). The values in the study group were higher than those of the control group (P<0.05). The Kappa values of MRI multi-B value imaging, 64-slice spiral CT and their combination in the diagnosis of liver regeneration nodules and pathological diagnosis in patients with hepatitis B-related cirrhosis were 0.821, 0.758 and 0.897, respectively, showing good consistency (P<0.05). The result of ROC curve analysis showed that the AUC values of MRI multi-B-value imaging, 64-slice spiral CT and the combined diagnosis of liver regenerating nodules in hepatitis B-related cirrhotic patients were 0.792, 0.739 and 0.942, respectively (P<0.05). Conclusion MRI multi-B-value imaging combined with 64-slice spiral CT is of an higher value in the diagnosis of liver regenerating nodules in hepatitis B-related cirrhotic patients.

Key words: Magnetic resonance imaging multi-B value imaging, 64-row helical computed tomography, Hepatitis B-related cirrhosis, Liver regeneration nodules, Diagnostic value

周培玉, 吴怡. MRI多b值成像联合64排螺旋CT在乙型肝炎肝硬化患者肝脏再生结节诊断中的价值[J]. 肝脏, 2024, 29(8): 929-933.

ZHOU Pei-yu, WU Yi. An analysis on the efficacy of MRI multi-B-value imaging combined with 64-slice spiral CT in the diagnosis of liver regenerating nodules in hepatitis B-related cirrhotic patients[J]. Chinese Hepatolgy, 2024, 29(8): 929-933.

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