【摘要】 目的 研究磁共振动态增强（DCEMRI）定量参数在肝细胞癌和肝良性肿瘤鉴别的意义，探索定量参数对肝脏占位性病变良恶性诊断的界值及其诊断效能。方法 对存在肝占位的25例患者进行DCEMRI扫描，经病理证实或通过随访确诊肝细胞癌和肝良性肿瘤共28个病灶，利用tissue4D后处理软件测定病灶及周围正常肝组织的定量参数值(K^trans、K_ep、V_e、iAUC),利用独立样本t检验比较肝细胞癌组、良性组病灶与周围正常肝组织的定量参数，同时比较2组病灶间的定量参数值，并通过绘制受试者工作特征曲线（ROC）来确定肝细胞癌和肝良性肿瘤间定量参数的最佳界值及其诊断效能。结果 良性组、肝细胞癌组病灶的各定量参数均值大于周围正常肝组织，其中良性组K^trans、iAUC差异有统计学意义（P<0.05）;肝细胞癌组K^trans、K_ep、iAUC差异有统计学意义（P<0.05）;肝细胞癌组和良性组比较，肝细胞癌组病灶的各定量参数均值大于良性组，K^trans、K_ep及iAUC的差异有统计学意义（P<0.05）。其中K^trans=0.215 min^-1时，敏感度为81.3%,特异度为66.7%,诊断效能大于K_ep（界值为0.477）、iAUC（界值为24.706）。结论 DCEMRI定量参数能为肝细胞癌和良性肿瘤的鉴别诊断提供参考。更多还原

【Abstract】 Objective To study the values of quantitative parameters of DCE-MRI in diagnosis of benign and malignant liver tumors and to explore its diagnostic efficacy.Methods Consecutive 25 patients with benign or malignant liver tumors underwent plain scanning and dynamic contrast-enhanced MRI,and total 28 lesions were confirmed by pathology or follow-up.The DCE-MRI quantitative parameters(K^trans,K_ep,V_e and iAUC) of the lesions and the surrounding normal liver tissue were acquired.The independent sample t test was used to compare the quantitative parameters between different tumors.The optimal parameters values of benign and malignant liver tumors were determined by plotting ROC curves.Results The mean quantitative parameters of HCC and benign lesions were larger than those of the surrounding normal liver tissue.K^trans,K_ep and iAUC between HCC and surrounding normal liver tissue had significant differences（P<0.05）,K^trans and iAUC between benign lesions and surrounding normal liver tissue had a significant difference（P<0.05）.K^trans,K_ep and iAUC between HCC and benign lesions had significant differences（P<0.05）.The diagnostic effectiveness of K^trans=0.215 min^-1,with sensitivity of 81.3% and specificity of 66.7%,was greater than that of K_ep=0.477 and iAUC=24.706.Conclusion The DCE-MRI quantitative analysis can provide a reference for the differential diagnosis of HCC from benign liver tumors.更多还原