MR动态增强扫描在上腹部疾病中的应用价值

目的评估MRI动态增强检查在上腹部病变诊断中的应用价值。方法收集行MRI检查的上腹部病变患者61例,所有病例均做平扫及动态增强扫描,动态后即刻扫描T1WI/SE得到普通增强扫描图像。将分别取得的MRI平扫 普通增强形态学及MRI平扫 动态增强形态学 动态曲线在上腹部病变的定性印象诊断的灵敏度,特异度,准确度,阳性预测值、阴性预测值进行比较。结果MRI平扫 动态增强在上腹部病变的定性印象诊断的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为82.61%,93.33%,85.25%,97.44%,63.64%;MRI平扫 普通增强上述指标分别为65.22%,73.33%,67.21%,88.24%,40.74%。MRI平扫 动态增强形态学 动态曲线对于检查上腹部病变的定性印象诊断的能力明显优于MRI平扫 普通增强形态学,差异具有显著性意义(P=0.027)。结论MRI动态增强检查对于鉴别上腹部肿块的良恶性有突出显著的作用,对病变的定性、定位、划定边界优于常规自旋回波增强扫描。

The application of enhanced dynamic MRI in the diagnosis of epigastric lesions

Objective Toevaluate the enhanced dynamic MRI in the diagnosis of epigastric lesions.Methods In total 61 patients with epigastric lesions were enrolled in the study and underwent enhanced dynamic MRI.Non-enhanced and dynamic enhanced scan were performed on all the patients,and conventional enhanced scan were done with T1WI/SE sequence immediately after the dynamic scan was finished.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of qualitative impressionistic diagnosis made with non-enhanced scan conventional enhanced scan,and qualitative impressionistic diagnosis made with the non-enhanced scan dynamic enhanced scan dynamic curve,were compared respectively.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of qualitative impressionistic diagnosis made with non-enhanced scan dynamic enhanced scan dynamic curve were 82.61%,93.33%,85.25%,97.44%,63.64%respectively;while with the non-enhanced scan conventional enhanced scan,those values were 65.22%,73.33%,67.21%,88.24%,40.74%respectively.The non-enhanced scan dynamic enhanced scan dynamic curve were obviously superior to non-enhanced scan conventional enhanced scan in qualitative impressionistic diagnosis,with a significant difference(P=0.027).Conclusion Enhanced dynamic MRI plays an important role in differential diagnosis of benign and malignant epigastric masses,which is better than routine spin-echo enhanced scan in determining,locating and demarcating the lesions.