多模融合影像评估再障雄激素治疗相关肝占位的临床研究

马华林; 隗功华; 张哲

doi:10.13898/j.cnki.issn.1000-2200.2023.03.025

多模融合影像评估再障雄激素治疗相关肝占位的临床研究

Clinical study on the evaluation of hepatic space-occupying lesions related to androgen treatment for aplastic anemia by multi-modality image fusion

摘要

摘要:
目的探究多模融合影像评估再生障碍性贫血(再障)雄激素治疗相关肝占位的临床价值。
方法选取经超声检查提示肝占位的雄激素治疗再障病人49例为观察组，另选取同期接受治疗的其他肝占位病变病人78例为对照组，所有病人均接受螺旋CT和MRI扫描，将CT与MRI双期图像进行融合，分析多模融合影像在再障雄激素治疗相关肝占位中的评估价值。
结果49例观察组病人经血清生物学检查、穿刺检查、术后组织病理学检查或临床及影像随访>6个月，最终证实观察组肝占位45例，病灶68个，对照组肝占位75例，病灶92个。观察组良性病变占比高于对照组(P < 0.05)，观察组融合图像的病灶检出率高于CT检查，对照组融合图像的病灶检出率高于CT和MRI检查，差异均有统计学意义(P < 0.05)，但观察组融合图像的病灶检出率与MRI检查差异无统计学意义(P>0.05)。以手术、病理穿刺及随访后的最终结果为“金标准”，螺旋CT检查诊断再障雄激素治疗相关肝占位的灵敏度、特异度和准确率分别为71.43%、87.50%和80.00%；MRI检查诊断的灵敏度、特异度和准确率分别为85.00%、88.00%和86.67%；融合图像诊断的灵敏度、特异度和准确率分别为100.00%、94.74%和97.78%，融合图像检查对再障雄激素治疗相关肝占位的诊断价值高于CT和MRI(P < 0.05)。
结论多模融合影像在评估再障雄激素治疗相关肝占位方面具有良好的诊断价值，可提高肝占位病灶的检出率，且诊断效能优于CT和MRI，值得临床推广与应用。

Abstract:
ObjectiveTo explore the clinical value of multi-modality image fusion in evaluating hepatic space-occupying lesions related to androgen treatment for aplastic anemia (AA).
MethodsTotal 49 patients with AA who had undergone androgen treatment and had hepatic space-occupying lesions detected by ultrasound were selected as the observation group.Meanwhile, 78 patients with the other hepatic space-occupying lesions were selected as the control group.All patients were subjected to spiral CT and MRI scanning.CT and MRI dual-phase images were fused, and the value of multi-modality image fusion in evaluating hepatic space-occupying lesions related to androgen treatment for AA was analyzed.
ResultsSerum biological examination, puncture, postoperative histopathological examination or more than 6 months of clinical and imaging follow-up found that there were 45 cases with 68 hepatic space-occupying lesions in the observation group and 75 cases with 92 hepatic space-occupying lesions in the control group.The proportion of benign lesions in the observation group was higher than that in the control group (P < 0.05).The proportion of lesions detected by fusion images was higher than that by CT in the observation group (P < 0.05), and the proportion of lesions detected by fusion images was higher than that by CT or MRI in the control group (P < 0.05), but the proportion of lesions detected by fusion images in the observation group was not significantly different from that in MRI examination (P>0.05).Taking surgical results, pathological results or follow-up results as the golden standard, the sensitivity, specificity and accuracy of spiral CT, MRI and fusion images to diagnose hepatic space-occupying lesions related to androgen treatment for AA were (71.43%, 87.50%, 80.00%), (85.00%, 88.00%, 86.67%) and (100.00%, 94.74%, 97.78%), respectively.The diagnostic value of fusion images was higher than that of CT or MRI (P < 0.05).
ConclusionsMulti-modality image fusion has good diagnostic value in evaluating the hepatic space-occupying lesions related to androgen therapy in aplastic anemia.It can improve the detection rate of hepatic space-occupying lesions, and its diagnostic efficiency is better than that of CT or MRI.It is worthy of clinical promotion and application.

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