[1]苏赞瑞,黄运福,林建军,等.DSA和钆塞酸二钠增强MRI对肝癌术后复发微小病灶诊断的比较研究 [J].介入放射学杂志,2017,(06):559-569.
 SU Zanrui,HUANG Yunfu,LIN Jianjun,et al.Comparative study of DSA vs Gd- EOB- DTPA- enhanced MRI in diagnosing postoperative recurrent tiny HCC lesions[J].journal interventional radiology,2017,(06):559-569.
点击复制

DSA和钆塞酸二钠增强MRI对肝癌术后复发微小病灶诊断的比较研究 



()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2017年06期
页码:
559-569
栏目:
临床研究
出版日期:
2017-06-25

文章信息/Info

Title:
Comparative study of DSA vs Gd- EOB- DTPA- enhanced MRI in diagnosing postoperative recurrent tiny HCC lesions
作者:
苏赞瑞 黄运福 林建军 龙 瑜 陈 璇 林祖华 李 凤
Author(s):
SU Zanrui HUANG Yunfu LIN Jianjun LONG Yu CHEN Xuan LIN Zuhua LI Feng
Department of Interventional Radiology, Tenth Clinical Medical College of Guangxi Medical University, Qinzhou, Guangxi Zhuang Autonomous Region 535000, China
关键词:
【关键词】 微小肝癌 数字减影血管造影 核磁共振 钆塞酸二钠
文献标志码:
A
摘要:
【摘要】 目的 对比研究DSA和钆塞酸二钠(Gd- EOB- DTPA)增强MRI对肝癌术后复发微小病灶的诊断效能,评估其诊断价值。方法 回顾性分析2011年9月至2016年3月收治的肝癌术后怀疑有微小复发病灶的患者38例,所有患者均经过DSA、DSA碘油CT和Gd- EOB- DTPA增强MRI检查,对比分析各检查方法诊断的阳性和阴性病例,计算诊断的灵敏度和特异度,所有病例均由2名放射科副主任医师根据诊断标准独立诊断,以手术或者穿刺病理结果以及至少6个月随访作为最终诊断依据。结果 38例患者,共发现47个病灶,病灶直径0.5~2.0 cm,平均(1.2±0.8) cm,其中41个病灶证实为复发微小肝癌,22个有病理结果,其余19个病灶经过随访证实。6个病灶为非肝癌病灶,全部由随访证实。所有病灶中,常规DSA诊断的灵敏度为73.2%,特异度为80.0%。DSA结合碘油CT诊断的灵敏度为90.2%,特异度为100%。Gd- EOB- DTPA增强MRI诊断的灵敏度为95.1%,特异度为100%。诊断效能之间统计学分析显示,常规DSA- DSA碘油CT以及常规DSA- MRI之间差异有统计学意义(P<0.05),碘油CT与MRI间差异无统计学意义(P>0.05)。结论 对肝癌术后的微小肝癌结节,DSA联合碘油CT的诊断效能和Gd- EOB- DTPA增强MRI类似,对于临床上不适合做MRI的患者,可以考虑采用DSA联合碘油CT作为替代检查手段。

参考文献/References:

[1] Bodzin AS, Busuttil RW. Hepatocellular carcinoma: advances in diagnosis, management, and long term outcome[J]. World J Hepatol, 2015, 7: 1157- 1167.
[2] 陈景标, 王 劲, 单 鸿. 小肝癌的手术与微创治疗的现状及研究进展[J]. 中华肝脏病杂志, 2014, 22: 868- 871.
[3] 丁以锟, 吕维富, 周春泽, 等. 术后预防性肝动脉化疗栓塞对肝癌患者生存的影响及预后相关因素分析[J]. 介入放射学杂志, 2014, 23: 299- 302.
[4] Attwa MH, El- Etreby SA. Guide for diagnosis and treatment of hepatocellular carcinoma[J]. World J Hepatol, 2015, 28, 7: 1632- 1651.
[5] 丛文铭, 步 宏, 陈 杰, 等. 原发性肝癌规范化病例诊断指南(2015版)[J]. 临床与实验病理学杂志, 2015, 31: 241- 246.
[6] 张建淮, 祁付珍, 许 刚, 等. 微小肝癌的诊治: 附17例诊治体会[J]. 中华肝胆外科杂志, 2009, 15: 628- 629.
[7] 刘光华, 夏 芳, 欧阳强. 肝动脉化疗栓塞对肝细胞癌切除术后预防复发的研究[J]. 介入放射学杂志, 2015, 24: 125- 129.
[8] Cristea CG, Gheonea IA, Sandulescu LD, et al. Considerations regarding current diagnosis and prognosis of hepatocellular carcinoma[J]. J Med Life, 2015, 8: 120- 128.
[9] 黄军祯, 王大健, 罗耀昌, 等. MRI与DSA对小肝癌的诊断价值比较[J]. 放射学实践, 2015, 30: 49- 53.
[10] 曹捍波, 张铁英, 严金岗. MRI、DSA和碘油CT联合应用对肝硬化结节癌变的诊断价值[J]. 中国癌症杂志, 2012, 22: 377- 380.
[11] Granata V, Catalano O, Fusco R, et al. The target sign in colorectal livermetastases: anatypical Gd- EOB- DTPA “uptake” on the hepatobiliary phase of MR imaging[J]. Abdom Imaging, 2015, 40: 2364- 2371.
[12] Yoshimura N, Saito K, Saguchi T, et al. Distinguishinghepatic hemangiomas from metastatic tumors using T1 mappingon gadoxetic- acid- enhanced MRI[J]. Magn Reson Imaging, 2013, 31: 23- 27.
[13] 黄海东, 曾蒙苏, 丁玉芹, 等. Gd- EOB- DTPA磁共振成像在慢性肝炎背景下小肝癌诊断中的应用[J]. 临床放射学杂志,2015, 34: 1085- 1089.
[14] 叶 枫, 宋 颖, 余小多, 等. 慢性肝病背景下钆塞酸二钠肝胆期成像对肝癌的检出与定性[J]. 中国医学影像技术, 2015, 32: 571- 575.
[15] Mitchell DG, Bruix J, Sherman M, et al. LI- RADS(Liver Imaging Reporting and Data System): summary, discussion, and consensus of the LI- RADS Management Working Group and future directions[J]. Hepatology, 2015, 61: 1056- 1065.
[16] Shah S, Shukla A, Paunipagar B. Radiological features of hepatocellular carcinoma[J]. J Clin Exp Hepatol, 2014, 4(Suppl 3): S63- S66.
[17] Asayama Y, Tajima T, Nishie A, et al. Uptake of Gd- EOB- DTPA by hepatocellular carcinoma: radiologic- pathologic corre- lation with special reference to bile production[J]. Eur J Radiol, 2011, 80: 243- 248.
[18] 梁 亮, 陈财忠, 饶圣祥, 等. 肝胆特异度磁共振对比剂Gd- EOB- DTPA在肝脏局灶性病变诊断中的应用研究[J]. 放射学实践, 2012, 27: 765- 770.

相似文献/References:

[1]尹国文,徐清宇,白向君,等.透视引导下经鼻置入瘘腔引流管治疗食管癌术后食管胃吻合口瘘[J].介入放射学杂志,2012,(02):140.
 YIN Guo-wen,XU Qing-yu,BAI Xiang-jun,et al.Fluoroscopically-guided transnasal tube insertion for the treatment of gastroesophageal anastomotic leak occurred after surgery for esophageal carcinoma[J].journal interventional radiology,2012,(06):140.
[2]庄奇新.亚段肺栓塞的肺动脉造影诊断——10例分析[J].介入放射学杂志,1992,(01):23.
[3]萧湘生,欧阳强,郝楠馨,等.支气管动脉灌注并栓塞治疗肺癌[J].介入放射学杂志,1994,(01):45.
[4]曾晓华,王颂章.颈外动脉选择性栓塞在颌面外科的应用[J].介入放射学杂志,1995,(04):212.
[5]陈左权,顾斌贤,张桂运,等.双C臂三维DSA在颅内动脉瘤栓塞治疗中的应用[J].介入放射学杂志,2006,(01):2.
 CHEN Zuo-quan,GU Bin-xian,ZHANG Gui-yun,et al.The utility of three dimentional DSA with bi-C-typed arms in the embolization of intracranial aneurysms[J].journal interventional radiology,2006,(06):2.
[6]董敏俊,范新东,石润杰.鼻咽血管纤维瘤术前双重介入栓塞的临床价值[J].介入放射学杂志,2006,(06):342.
 DONG Min-jun,FAN Xin-dong,SHI Run-jie.Clinical value of pre-operative double embolization for nasopharyngeal angiofibroma[J].journal interventional radiology,2006,(06):342.
[7]郭德文,叶剑定,凌美玲,等.时差减影法临床应用及其在心脏疾患中诊断价值的探讨[J].介入放射学杂志,1996,(02):64.
[8]周 兵,李明华,王 武,等.三维容积重建技术在栓塞后颅内动脉瘤DSA随访中的价值探讨[J].介入放射学杂志,2010,(10):762.
 ZHOU Bing,LI Ming-hua,WANG Wu,et al.The clinical value of 3-dimensional volume-rendering technique in the follow-up checkups with DSA for intracranial aneurysms after embolization treatment[J].journal interventional radiology,2010,(06):762.
[9]李 杰,赵俊功,朱悦琦,等.小腿加压3.0 T MRA评估糖尿病下肢血管病变的价值探讨[J].介入放射学杂志,2011,(03):231.
 LI Jie,ZHAO Jun-gong,ZHU Yue-qi,et al.Evaluation of diabetic peripheral arterial disease in lower limb by using 3.0 T contrast-enhanced MR angiography with simultaneous calf compression[J].journal interventional radiology,2011,(06):231.
[10]曹厚德.正在使用二甲双胍的糖尿病患者不宜作DSA造影检查[J].介入放射学杂志,2011,(05):339.

备注/Memo

备注/Memo:
(收稿日期:2016-09-05)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2017-06-13