CAJ | 학술논문

目的：探讨在常规 MRI扫描的基础上增加DWI序列对乙肝肝硬化背景微小肝癌(≤1 cm)的检测价值。方法51例乙肝肝硬化患者共54个微小肝癌,同时行常规 MRI(T2 WI+T1 WI 双回波序列+动态增强)及 DWI 扫描。由2位阅片者采用双盲法分析常规 MRI 图像及联合常规 MRI +DWI 图像,记录病灶的信号特点、强化方式及阅片者的信心评分,比较2种成像模式下阅片者的信心评分及一致性,并通过 ROC 曲线评估阅片者对微小肝癌的诊断能力,以及检测微小肝癌的敏感性、特异性和阳性预测值。结果增加 DWI 图像后：①2位阅片者检测微小肝癌的信心评分提高,差异有统计学意义(P <0.05),同时,2位阅片者检测微小肝癌的一致性增加。②2位阅片者检测微小肝癌的 ROC 曲线下面积均提高,差异有统计学意义(P <0.05)。③2位阅片者检测微小肝癌的敏感性及阳性预测值差异均无统计学意义(P >0.05),特异性差异均有统计学意义(P <0.05)。结论在常规 MRI 扫描的基础上增加 DWI 序列有助于提高对乙肝肝硬化背景微小肝癌诊断能力。
목적：탐토재상규 MRI소묘적기출상증가DWI서렬대을간간경화배경미소간암(≤1 cm)적검측개치。방법51례을간간경화환자공54개미소간암,동시행상규 MRI(T2 WI+T1 WI 쌍회파서렬+동태증강)급 DWI 소묘。유2위열편자채용쌍맹법분석상규 MRI 도상급연합상규 MRI +DWI 도상,기록병조적신호특점、강화방식급열편자적신심평분,비교2충성상모식하열편자적신심평분급일치성,병통과 ROC 곡선평고열편자대미소간암적진단능력,이급검측미소간암적민감성、특이성화양성예측치。결과증가 DWI 도상후：①2위열편자검측미소간암적신심평분제고,차이유통계학의의(P <0.05),동시,2위열편자검측미소간암적일치성증가。②2위열편자검측미소간암적 ROC 곡선하면적균제고,차이유통계학의의(P <0.05)。③2위열편자검측미소간암적민감성급양성예측치차이균무통계학의의(P >0.05),특이성차이균유통계학의의(P <0.05)。결론재상규 MRI 소묘적기출상증가 DWI 서렬유조우제고대을간간경화배경미소간암진단능력。
Objective To assess the added value of diffusion weighted imaging (DWI)in combination with conventional magnetic resonance imaging (MRI)in detection of micro-small hepatocellular carcinomas (MHCC).Methods A total of 5 1 hepatitis B induced cirrhotic patients with 54 MHCC lesions,all underwent conventional MRI (T2 WI+ T1 WI double eho sequences+ dynamic contrast enhancement)and DWI.Two separate blind image analyses of the conventional MRI set and the combined conventional MRI and DWI sets were performed.The signal characteristic of MHCC,the enhancement style,and the confidence scores for MHCC detection were recorded.Confidence scores of the two imaging sets for MHCC detection and consistency of the two observers were compared, diagnostic efficacy of each imaging set was evaluated by receiver operating characteristic (ROC)curve analysis,sensitivity,specificity and positive predictive values (PPV)were calculated and analyzed.Results ①The addition of DWI led to a significantly (P <0.05) increasing confidence score with higher detecting of MHCC by both observers,and the consistency of two readers also increased.②The area under the ROC curve of the second imaging set was significantly higher (P <0.05)than that of the first set by both observ-ers.③There were no significant differences (P >0.05)in sensitivity and PPV between the two image sets,significantly differences (P <0.05)was observed in specificity.Conclusion Adding DWI to conventional MRI may improve the diagnostic efficacy of MHCC with hepatitis B induced cirrhotic liver.