The application of enhanced dynamic MRI in the diagnosis of epigastric lesions

Objective: To evaluate the enhanced dynamic MRI in the diagnosis of epigastric lesions. Methods: In total 61 patients with epigastric lesions were enrolled in the study and underwent enhanced dynamic MRI. Non-enhanced and dynamic enhanced scan were performed on all the patients, and conventional enhanced scan were done with T1WI/SE sequence immediately after the dynamic scan was finished. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of qualitative impressionistic diagnosis made with non-enhanced scan + conventional enhanced scan, and qualitative impressionistic diagnosis made with the non-enhanced scan + dynamic enhanced scan + dynamic curve, were compared respectively. Results: The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of qualitative impressionistic diagnosis made with non-enhanced scan + dynamic enhanced scan + dynamic curve were 82.61%, 93.33%, 85.25%, 97.44%, 63.64% respectively; while with the non-enhanced scan + conventional enhanced scan, those values were 65.22%, 73.33%, 67.21%, 88.24%, 40.74% respectively. The non-enhanced scan + dynamic enhanced scan + dynamic curve were obviously superior to non-enhanced scan + conventional enhanced scan in qualitative impressionistic diagnosis, with a significant difference (P=0.027). Conclusion: Enhanced dynamic MRI plays an important role in differential diagnosis of benign and malignant epigastric masses, which is better than routine spin-echo enhanced scan in determining, locating and demarcating the lesions. (authors)