CAJ | 학술논문

目的评价1.5 T MRI常用检查序列：常规T2WI、DWI、动态增强扫描(DCEI)在肝脏局灶性病变(FLLs)诊断中的应用价值。材料与方法由2名研究者分析23例FLLs患者肝脏T2WI、DWI和DCEI图像，按Couinaud八段分法分别记录所有检出的病灶并测量其直径，将结果与“标准诊断”对照，计算单独应用T2WI、DWI和DCEI，以及DCEI联合DWI四种检查方法的病灶检出率。对所有检出的病灶按5分法对其良恶性进行评分，作受试者工作特征(ROC)曲线分析。采用SPSS 16.0统计软件和SASS统计软件包对数据进行统计学分析，P≤0.05差异有统计学意义。结果 T2WI、DWI、DCEI三种方法检出率两两比较，DWI序列对直径≤5 mm病灶检出率较T2WI低(P=0.004)，其余三种检查方法的各项检出率之间的差异均无统计学意义(P≥0.052)。DCEI联合DWI的各项检出率均为100%，总检出率均较T2WI、DWI和DCEI序列单独应用时高，且差异有统计学意义(P≤0.006)；对良性病灶和直径≤5 mm病灶的检出率较DWI高，差异有统计学意义(P≤0.029)。DCEI联合DWI的Az值(0.982)最大，与DCEI间差异无统计学意义(P=0.075)，与DWI、T2WI间的差异有统计学意义(P≤0.0199)。结论单独运用DWI或DCEI序列相对于常规T2WI，并不能提高MRI对FLLs的检出率。DCEI联合DWI序列相对于单独应用T2WI、DWI或DCEI序列能提高MRI对FLLs的总检出率。DCEI联合DWI相对于DWI序列能提高良性病灶和直径≤5 mm病灶的检出率，提高了MRI对FLLs的诊断效能。
목적평개1.5 T MRI상용검사서렬：상규T2WI、DWI、동태증강소묘(DCEI)재간장국조성병변(FLLs)진단중적응용개치。재료여방법유2명연구자분석23례FLLs환자간장T2WI、DWI화DCEI도상，안Couinaud팔단분법분별기록소유검출적병조병측량기직경，장결과여“표준진단”대조，계산단독응용T2WI、DWI화DCEI，이급DCEI연합DWI사충검사방법적병조검출솔。대소유검출적병조안5분법대기량악성진행평분，작수시자공작특정(ROC)곡선분석。채용SPSS 16.0통계연건화SASS통계연건포대수거진행통계학분석，P≤0.05차이유통계학의의。결과 T2WI、DWI、DCEI삼충방법검출솔량량비교，DWI서렬대직경≤5 mm병조검출솔교T2WI저(P=0.004)，기여삼충검사방법적각항검출솔지간적차이균무통계학의의(P≥0.052)。DCEI연합DWI적각항검출솔균위100%，총검출솔균교T2WI、DWI화DCEI서렬단독응용시고，차차이유통계학의의(P≤0.006)；대량성병조화직경≤5 mm병조적검출솔교DWI고，차이유통계학의의(P≤0.029)。DCEI연합DWI적Az치(0.982)최대，여DCEI간차이무통계학의의(P=0.075)，여DWI、T2WI간적차이유통계학의의(P≤0.0199)。결론단독운용DWI혹DCEI서렬상대우상규T2WI，병불능제고MRI대FLLs적검출솔。DCEI연합DWI서렬상대우단독응용T2WI、DWI혹DCEI서렬능제고MRI대FLLs적총검출솔。DCEI연합DWI상대우DWI서렬능제고량성병조화직경≤5 mm병조적검출솔，제고료MRI대FLLs적진단효능。
Objective: The purpose of this study was to compare the diagnostic performances of conventional respiratory triggered T2WI, DWI and dynamic contrast enhanced imaging sequences in the evaluation of focal liver lesions (FLLs). Materials and Methods:We collected liver MRI data of twenty-three patients from 2011.9 to 2013.1. Two observers reviewed T2WI, DWI and DCEI for FLLs detection and characterization, then compared T2WI, DWI, DCEI and DCEI combined with DWI for FLLs detection. The reviewers then characterized each detected lesion using a 5-point scale, the sensitivity, speciifcity and areas under the receiver operating characteristic curve (Az) for the detection of liver lesions were evaluated using receiver operating characteristic analysis. Results:Overall detection rate was equal for T2WI, DWI and DCEI, but ≤5 mm lesions detection rate was lower for DWI (44.44%) versus T2-weighted imaging (66.67%) (P=0.004). Overall detection rate of DCEI combined with DWI (100%) was signiifcantly higher than T2WI (87.14%), DWI (88.57%) and DCEI (87.14%) alone (P≤0.006). Benign and≤5 mm lesions detection rate are higher for DCEI combined with DWI (100%、100%)versus DWI (87.23%、44.44%) (P≤0.029). There was no significant difference between the three image sets (T2WI, DWI,DCEI) in the detection of FLLs with regards to Az (≥0.075). However, the Az values of DCEI combined with DWI (0.982) was signiifcantly higher than those of DWI (0.886) and T2WI (0.858) (P≤0.0199). Conclusions:The diagnostic performance of DCEI and DWI is equal to conventional respiratory triggered T2WI. Combination of DCEI and DWI increases the lesions detection and diagnostic performance.