动态增强磁共振定量参数诊断肝脏占位性病变良恶性效能分析

目的 探讨应用动态增强磁共振(DCE-MRI)扫描定量参数诊断肝脏占位性病变良恶性的效能。方法 2019年2月～2022年2月我院经手术或穿刺活检组织病理学检查证实的88例肝脏良恶性病变患者，其中肝脏良性病变组47例和恶性病变组41例。所有患者均接受DCE-MRI检查，测量病变的平均强化时间(MET)、正性增强积分(PEI)、最大上升斜率(MSI)和最大下降斜率(MSD)。采用荧光定量PCR法检测组织衍生生长因子-1(Cripto-1)、Kruppel样因子(KLF4)、同源盒蛋白A9(HOXA9)和跨膜蛋白3(IFITM3)mRNA水平。绘制受试者工作特征曲线(ROC)分析MR检查测量的MET、PEI、MSI和MSD诊断肝脏占位性病变性质的效能。结果 恶性病变组MET、PEI和MSI分别为(516.5±40.2)s、(32.4±6.3)和(99.6±17.8),显著低于肝脏良性病变组【分别为(574.3±50.9)s、(256.7±22.7)和(271.6±25.3),P<0.05】,而MSD为(114.6±14.2),显著高于肝脏良性病变组【(85.4±10.9),P<...

Performance of quantitative parameters by dynamic contrast-enhanced magnetic resonance imaging in the diagnosis of benign and malignant hepatic space-occupying lesions

Objective The aim of this study was to explore the performance of quantitative parameters by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the diagnosis of benign and malignant hepatic space-occupying lesions. Methods A total of 88 patients with hepatic space-occupying lesions confirmed by histopathological examination after surgery or fine needle aspiration biopsy were encountered in our hospital between February 2019 and February 2022. The histopathological results showed that there were 47 patients with benign hepatic lesions and 41 patients with liver cancer. All patients underwent DCE-MRI scanning to measure the mean enhancement time (MET), positive enhancement integral (PEI), maximum slope of increase (MSI) and maximum slope of decrease (MSD). The liver tissue Cripto-1, Kruppel-like factor (KLF4), homolobox A9(HOXA9) and transmembrane protein 3(IFITM3) mRNA levels were detected by fluorescence quantitative polymerase chain reaction (PCR). The diagnostic efficacy of parameter was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC). Results The MET, PEI and MSI in the malignant lesions were (516.5±40.2)s,(32.4±6.3) and (99.6±17.8), all significantly lower than (574.3±50.9)s,(256.7±22.7) and (271.6±25.3), respectively, P<0.05], while the MSD was (114.6±14.2), significantly higher than (85.4±10.9), P<0.05] in the benign lesions; the Cripto-1 and IFITM3 mRNA levels in the malignant lesions were (130.3±17.5) and (141.8±19.2), both significantly higher than (101.5±14.2) and (103.5±13.6), respectively, P<0.05], while the KLF4 and HOXA9 mRNA levels were (70.4±8.6) and (65.7±6.9), both significantly lower than (99.8±12.6) and (98.8±11.4), respectively, P<0.05] in benign lesions; the ROC analysis showed that the AUC was 0.900, with the sensitivity of 96.0％, and the specificity of 80.0％, when the MET, PEI, MSI and MSD combination (equal to or greater than 534.7 s, 77.9, 136.8 and 100.5, respectivyly, as the cut-off-value) in predicting intrahepatic malignant lesions, superior to any parameter of them (P<0.05). Conclusion The quantitative parameters obtained by DCE-MRI scan are helpful for differential diagnosis of benign and malignant hepatic space-occupying lesions, which warrants further investigation.