钆贝葡胺MRI增强在肝硬化结节与小肝癌诊断鉴别中的应用

目的探究钆贝葡胺(莫迪司)磁共振(MRI)增强在肝硬化结节与小肝细胞癌(HCC)诊断鉴别中的应用效果。方法回顾性分析我院86例经病理检查确诊为肝硬化合并肝内结节患者临床资料。记录86例患者病理检查结果,比较小HCC与肝硬化结节MRI增强扫描信号强度、医师对MRI增强动态三期及动态四期的诊断信心评分差异,并分析MRI增强动态三期及动态四期对小HCC和肝硬化结节的诊断准确性。结果86例患者共91个结节,其中小HCC65个(71.43%),肝硬化结节21个(23.08%),胆管细胞癌2个(2.20%),局灶性结节增生2个(2.20%),腺瘤1个(1.10%)。小HCC与肝硬化结节在动脉期、门静脉期、延迟期及肝胆期信号强度比较,差异均有统计学意义(P<0.05)。医师对MRI增强动态三期诊断信心评分明显低于动态四期诊断信心评分(P<0.05)。MRI增强动态三期对小HCC及肝硬化结节诊断准确率均低于动态四期(P<0.05)。结论钆贝葡胺MRI动态增强扫描在肝硬化结节和小HCC鉴别诊断中应用效果显著,能在提升医师诊断信心的同时,提高诊断准确性,临床使用价值较高。

Application of Gadobenate Dimeglumine MRI Enhancement in Diagnosis and Differentiation of Liver Cirrhosis Nodules and Small Hepatocellular Carcinoma

Objective To explore the application effects of Gadobenate Dimeglumine(MultiHance) magnetic resonance imaging(MRI) enhancement in the diagnosis and differentiation of liver cirrhosis nodules and small hepatocellular carcinoma(HCC). Methods The clinical data of 86 patients with liver cirrhosis and intrahepatic nodules confirmed by pathological examination in our hospital were retrospectively analyzed. The pathological findings of 86 patients were recorded. The differences of MRIenhanced scan signal intensity between small HCC and liver cirrhosis nodules, and the diagnostic confidence score of physicians on MRI-enhanced dynamic three-phase diagnosis and dynamic four-phase diagnosis were compared. Diagnostic accuracies of MRI-enhanced dynamic three-phase diagnosis and dynamic four-phase diagnosis on small HCC and liver cirrhosis nodules were analyzed. Results A total of 91 nodules were found in 86 patients, including 65 small HCC(71.43%), 21 liver cirrhosis nodules(23.08%), 2 cholangiocarcinoma(2.20%), and 2 focal nodular hyperplasia(2.20%) and 1 adenoma(1.10%). There were significant differences in the signal intensities between small HCC and liver cirrhosis nodules in arterial phase, portal vein phase, delayed phase and hepatobiliary phase(P<0.05). The diagnostic confidence score of physicians on MRIenhanced dynamic three-phase diagnosis was significantly lower than that of dynamic four-phase diagnosis(P<0.05). The accuracy rates of diagnosis of small HCC and liver cirrhosis nodules by MRI-enhanced dynamic three-phase diagnosis were lower than those by dynamic four-phase diagnosis(P<0.05). Conclusion Gadobenate Dimeglumine MRI dynamic contrast-enhanced scan has significant application effects in the differential diagnosis of liver cirrhosis nodules and small HCC. And it can improve the diagnostic confidence of physicians and enhance the diagnostic accuracy, and it has high clinical application value.