摘要
目的:通过比较弥散加权成像(DWI)与多层螺旋CT(MSCT)多期增强扫描对肝癌的检出敏感性、特异性、阳性预测值及阴性预测值,评价DWI对肝癌的诊断价值。方法:对55例CT平扫疑为肝癌的患者进行常规磁共振扫描+DWI及MSCT多期增强扫描。由两名高级职称的影像诊断医师进行双盲阅片,达成一致的诊断意见,统计两种检查方式对小肝癌(直径≤3cm)和非小肝癌(直径>3cm)病灶的检出敏感性、特异性、阳性预测值及阴性预测值,并对两种检查方式对小肝癌的诊断能力行受试者工作曲线(ROC)分析。结果:对于小肝癌病灶,DWI对病灶的检出敏感性、特异性、阳性预测值及阴性预测值分别为94.4%、50.0%、94.4%、50.0%,而MSCT多期增强扫描为55.6%、50.0%、90.9%、11.1%;对于非小肝癌病灶,DWI对病灶的检出敏感性、特异性、阳性预测值及阴性预测值分别为89.4%、66.7%、97.2%、33.3%,而MSCT为92.3%、33.3%、94.7%、25.0%。对于小肝癌病灶,ROC曲线下平均面积DWI为0.944,高于MSCT多期增强扫描的0.889,并且差异有统计学意义(P<0.05)。结论:应用DWI有助于提高肝癌尤其是小肝癌的检出敏感性、阳性预测值及阴性预测值。
Objective To evaluate the diagnostic value of diffusion-weighted imaging（DWI） for hepatic cancer by comparing the sensitivity,specificity,positive predictive value,and negative predictive value of DWI and multi-phase enhanced MSCT scan for the detection of hepatic cancer.Methods 55 patients with suspected hepatic cancer detected by CT scan received MRI scan plus DWI and conventional multi-phase enhanced MSCT scan.The results were read by two senior titles diagnostic imaging physicians under the method of double-blind.The sensitivity,specificity,positive predictive value,and negative predictive value of the two methods for the detection of small hepatocellular carcinoma（diameter≤3 cm） and non-small hepatocellular carcinoma（diameter 3 cm） were compared;and the subjects ability to line working curve（ROC） analysis was assigned to evaluate these two kinds of inspection methods for the diagnosis of small hepatocellular carcinoma.Results For small hepatocellular carcinoma,the sensitivity,specificity,positive predictive value,and negative predictive values of DWI were 94.4%,50.0%,94.4%,and 50.0%,while those of multi-phase enhanced MSCT scan were 55.6%,50.0%,90.9%,and 11.1%;as for non-small hepatocellular carcinoma,those of DWI and multi-phase enhanced MSCT scan were 89.4%,66.7%,97.2%,33.3%,and 92.3%,33.3%,94.7%,25.0%,respectively.The mean area under the ROC of DWI and multi-phase enhanced MSCT scan were 0.944 and 0.889,respectively,for small hepatocellular carcinoma（P 0.05）.Conclusion DWI could improve the sensitivity,positive predictive value and negative predictive value of the detection of hepatic cancer,especially small hepatocellular carcinoma.
出处
《实用医学杂志》
CAS
北大核心
2012年第10期1720-1723,共4页
The Journal of Practical Medicine
基金
山东省自然科学基金(编号:Y2008C177)
关键词
肝肿瘤
磁共振成像
DWI
ADC值
CT增强扫描
Liver neoplasms
Magnetic resonance imaging
Diffusion-weighted imaging
Apparent diffusion coefficient
Contrast-enhanced computed
