目的探讨磁共振非对称回波的最小二乘估算法迭代水脂分离(iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification,IDEAL-IQ)序列在甲胎蛋白(alpha fetoprotein,AFP)阴性肝细胞癌(hepatocellular carcinoma,HCC)和肝脏局灶性结节性增生(focal nodular hyperplasia,FNH)诊断和鉴别诊断中的价值。材料与方法回顾性分析AFP阴性HCC 28例和FNH 15例患者资料,所有患者术前均行MRI肝脏常规扫描及IDEAL-IQ序列扫描,在后处理工作站测量病灶及背景肝组织弛豫率值(R2;)、脂肪分数(fat fraction,FF)值,统计学分析比较FF值、R2;值之间的差异,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析比较相关参数在两组病变中的诊断效能。结果HCC组和FNH组FF;值、R2^(*)_(肝脏)/R2^(*)_(病灶)分别为8.28%±5.76%、2.98±1.08和2.56%±1.25%、1.90±0.50,两者之间差异具有统计学意义(P0.05)。FF_(病灶)值及R2^(*)_(肝脏)/R2^(*)_(病灶)曲线下面积(area under the curve,AUC)分别为0.923(P<0.001)、0.883(P=0.56)。结论FF;值及R2^(*)_(肝脏)/R2^(*)_(病灶)对于两者均具有鉴别诊断价值,FF;值AUC大于R2^(*)_(肝脏)/R2^(*)_(病灶)。
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