【作者】 刘敏；

【导师】 周翔平；

【作者基本信息】 四川大学 ， 影像医学与核医学， 2004， 硕士

【摘要】 目的:比较多排螺旋CT与钆贝葡胺(Gd-BOPTA)增强MRI对肝癌的诊断价值,并了解Gd-BOPTA增强MRI影像是否有利于肝脏病灶的检出和定性诊断。 材料与方法:收集四川大学华西医院在2003年8月至2004年3月收治的30名患者。多排螺旋CT采用常规轴位双期增强扫描。磁共振平扫采用flash序列及haste序列扫描。增强后选择与平扫相同的T1WI序列进行扫描。以0.1mmol/kg(0.2ml/kg)的造影剂用量静脉注射给药。给药后立即扫描,60—80分钟后再次扫描。图片分为多排螺旋CT扫描、MRI平扫+Gd-BOPTA动态增强扫描及联合扫描(平扫+Gd-BOPTA动态MRI增强+延迟)三组。比较其病灶检出的敏感度以及对恶性病灶定性诊断的敏感度、特异度和准确度。测量MRI平扫与延迟扫描肝脏原发性肝癌相对强化率。 结果:病灶检出的敏感度多排螺旋CT扫描、平扫+Gd-BOPTA动态增强扫描、及联合扫描(平扫+Gd-BOPTA动态MRI增强+延迟)三组分别为74%、80%、95%,第三组与前两组比较差异有统计学意义(P<0.05)。对肝脏恶性病灶诊断的敏感度三组分别为69%、76%、93%;特异度分别为71%、71%、88%;准确度分别为69%、75%、92%。三组比较对更多还原

【Abstract】 PURPOSE: To compare the diagnostic value of gadobenate dimeglumine (Gd-BOPTA)-enhanced magnetic resonance(MR) imaging with multi-detector helical CT(MDCT), and to analyze the potential of Gd-BOPTA-enhanced MR imaging for the detection and characterization of liver lesions.MATERIALS AND METHODS: 30 patients with hepatic lesions in Huaxi hospital of Sichuan University from August,2003 to March,2004 were evaluated . Conventional axial dual-phase enhanced scanning was performed in MDCT examination. Flash and haste sequences were performed before enhancement, the same flash sequences were performed during and after the intravenous administration of 0.1mmol/kg (0.2ml/kg) Gd-BOPTA 60-80 minutes later. The potential of lesion detection and characterization were analyzed among MDCT; nonenhaced and dynamic MRI together ; and combined MRI(nonenhanced, dynamic and static MRI). The relative enhancement ratio of the 27 primary hepatocarcinoma lesions was calculated.Rresults: For lesion detection the sensitivity of MDCT; nonenhaced anddynamic MRI together; and combined MRI was 74 % > 80 % ^ 95 % respectively. The combined MRI was superior to the others (P<0.05). For the characterization of the malignant lesions, the accuracy wa69% > 75 %n 92 % respectively. The combined MRI was superior to the others(PO.05). The sensitivity for the characterization was 69% ^ 76% > 93% respectively; the specificity for the characterization was 71!^ 715^ 88% respectively. No significant difference was found among the three groups with regard to the specificity and sensitivity. The relative enhancement ratio of all the 27 primary hepatocarcinoma lesions was <1 after enhancement.CONCLUSION: The detection and characterization of hepatic lesions were improved by Gd-BOPTA enhanced MRI compared with MDCT.更多还原