CAJ | 학술논문

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。
목적：연구 MRI 동태대비증강정량삼수대간장량악성병변적적진단개치。방법채용 MRI 소묘의，대42례간장점위환자진행동태증강소묘，분별측량정량혈류동역학삼수：용량전이상수（Ktrans ）、혈관외세포외간극용적비（Ve）、속솔상수（Kep）화혈관공간용적분수（Vp），혈관류조화간암조정량삼수행독립양본 t 검험；대혈관류조여간암조간회제수시자특성곡선（ROC）곡선。결과혈관류여간암 Ktrans 급 Kep 치차이균유통계학의의（P ＜0．05），이 Ve、Vp 차이무통계학의의（P ＞0．05）。혈관류여간암 Ktrans 、Ve、Kep、Vp 적 ROC 곡선하면적분별위0．907、0．661、0．966、0．582，이최대약등지수득도적최가진단절점치，칙정량삼수판단급감별혈관류화간암적민감도분별위85．0％、80．0％、95．0％、65．0％，특이도분별위86．3％、59．1％、81．8％、54．5％。결론 MRI 정량동태대비증강혈류동역학삼수 Ktrans 、Kep 대간장량악성병변구유흔고적감별진단개치。
Objective To evaluate the value of quantitative dynamic contrast enhanced MRI in the diagnosis of benign and malignant liver lesions.Methods 42 patients of liver tumors underwent MRI examination. MR scanner was used to obtain the quantitative MR pharmacokinetic parameters:Ktrans (volume transfer constant),Kep (exchange rate constant) and Ve (extravascular extracellular volume fraction),Vp (volume fraction of plasma space).The mean Ktrans ,Kep,Ve of malignant (liver cancer)and enign (liver hemangioma) were compared with independent sample t test.receiver operating characteristic curve (ROC)analysis were used for comparing the differences between liver cancer and liver hemangioma. Results There was significant difference between liver cancer and liver hemangioma in Ktrans ,Kep (P <0.05).The areas under the ROC curve (AUC)of Ktrans ,Ve,Kep and Vp between liver cancer and liver he-mangioma were 0.907,0.661,0.966 and 0.582,respectivly.The sensitivity of Ktrans ,Ve,Kep and Vp was 85.0%,80.0%,95.0%,65.0% and the specificity of Ktrans ,Ve,and Kep was 86.3%,59.1%,81.8%, 54.5% for the differential diagnosis of liver lesions with the maximum Youden′s index as cut off.Conclu-sion The differential diagnosis of benign and malignant liver lesions by Ktrans ,Kep derived from DCE-MRI is valuable.