Eur Radiol:基于钆塞酸二钠增强MRI的诊断模型让含胆管细胞癌成分的恶性肿瘤现原形!

2021-01-05 shaosai MedSci原创

基于钆塞酸二钠增强MRI的诊断模型让含胆管细胞癌成分的恶性肿瘤现原形!

目的:LI-RADS M(LR-M)分类描述了可能或肯定是恶性的肝脏病变,但对肝细胞肝癌高危人群的诊断特异性并不高。 鉴别不同LR-M病变对于治疗和预后至关重要,特别是含胆管细胞癌成分的肿瘤(M-CC)。 因此,我们的目的是建立以钆塞酸二钠增强MRI为基础的诊断模型,该模型包括血清肿瘤标志物和M-CC的LI-RADS影像学特征。

方法:从前瞻性收集的跨度3年的数据库中,回顾性检索连续的仅存在LR-M病变的高危患者(无共存的LR-4或者LR-5病变)。 将肝内胆管癌(ICC)以及混合型肝细胞肝癌和胆管细胞癌(c-HCC-CCA)归为M-CC。结合病变的LI-RADS特征以及临床相关血清肿瘤标志物,通过对组织学进行逻辑回归分析生成M-CC诊断模型。 使用受试者工作曲线的曲线下面积(AUC)、灵敏度和特异性来评价对每位患者病变的诊断效能。

结果:本项研究共纳入45例患者,其中肝细胞肝癌占42.2%(19/45),ICC占33.3%(15/45),c-HCC-CCA占13.3%(6/45)以及11.1%(5 / 45)的其他肝脏病变。 碳水化合物抗原(CA)19-9> 38 U / mL、甲胎蛋白(AFP)> 4.8 ng / mL以及没有LI-RADS“病灶内出血”的特征是M-CC的重要预测指标。 结合三个预测因子表明AUC为0.862,敏感性为76%,特异性为88%。 满足所有三个标准的M-CC的风险为98%(AUC为0.690,敏感性为38%,特异性为100%)。

结论:在患有LR-M病变的高危患者中,结合CA19-9、AFP和LI-RADS“病灶内出血”的特征可实现M-CC的高诊断效能。 当所有三个标准都满足时,M-CC的特异性为100%。

原始出处:

Hanyu Jiang,Bin Song,Yun Qin,et al. Diagnosis of LI-RADS M lesions on gadoxetate-enhanced MRI: identifying cholangiocarcinoma-containing tumor with serum markers and imaging features.PMID:33245494DOI:10.1007/s00330-020-07488-z

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    2021-01-05 CHANGE

    梅斯里提供了很多疾病的模型计算公式,赞一个!

    0

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