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目的研究MRI动态对比增强定量参数对肝脏良恶性病变的的诊断价值。方法采用MRI扫描仪,对42例肝脏占位患者进行动态增强扫描,分别测量定量血流动力学参数:容量转移常数(Ktrans)、血管外细胞外间隙容积比(Ve)、速率常数(Kep)和血管空间容积分数(Vp),血管瘤组和肝癌组定量参数行独立样本t检验;对血管瘤组与肝癌组间绘制受试者特性曲线(ROC)曲线。结果血管瘤与肝癌Ktrans及Kep值差异均有统计学意义(P<0.05),而Ve、Vp差异无统计学意义(P>0.05)。血管瘤与肝癌Ktrans、Ve、Kep、Vp的ROC曲线下面积分别为0.907、0.661、0.966、0.582,以最大约登指数得到的最佳诊断切点值,则定量参数判断及鉴别血管瘤和肝癌的敏感度分别为85.0%、80.0%、95.0%、65.0%,特异度分别为86.3%、59.1%、81.8%、54.5%。结论 MRI定量动态对比增强血流动力学参数Ktrans、Kep对肝脏良恶性病变具有很高的鉴别诊断价值。
Objective To study the diagnostic value of contrast-enhanced quantitative MRI in the diagnosis of benign and malignant liver diseases. Methods Forty-two patients with liver space-occupying lesions underwent dynamic contrast-enhanced MRI scanning. Quantitative hemodynamic parameters were measured: Ktrans, Ve, Kep, (Vp), hemangiomas and hepatocellular carcinoma (HCC) were measured by using independent samples t-test. The ROC curve was drawn between hemangiomas and HCC groups. Results There were significant differences in Ktrans and Kep values between hemangiomas and hepatocellular carcinoma (P <0.05), but Ve and Vp had no significant difference (P> 0.05). The area under the ROC curve of hemangiomas and liver cancer Ktrans, Ve, Kep, Vp were 0.907,0.661,0.966,0.582 respectively, the best diagnostic cut-off value was obtained with the maximum Youden index, then the quantitative parameters were used to judge and differentiate hemangiomas and hepatocellular carcinomas The sensitivity was 85.0%, 80.0%, 95.0%, 65.0%, and the specificity was 86.3%, 59.1%, 81.8% and 54.5% respectively. Conclusions MRI quantitative dynamic contrast-enhanced hemodynamic parameters Ktrans and Kep have high differential diagnostic value in benign and malignant liver diseases.