MRI与SCT在原发性肝癌经TACE治疗后随访的对比研究

A Comparison Study of MRI and SCT Examination in the Follow-up of HCC Treated with TACE

目的对比分析MRI与螺旋CT(SCT)在原发性肝癌经肝动脉栓塞化疗(TACE)后随访中的应用价值。资料与方法经TACE治疗的原发性肝癌患者31例,分别于治疗前1周及治疗后3个月行MRI及SCT检查,MRI包括平扫和动态增强扫描;SCT检查包括平扫和增强后三期扫描。并于MRI与SCT检查后1周内行DSA。以DSA结果为金标准,比较MRI和SCT对于TACE后肿瘤的残留与复发显示情况。结果DSA检查发现30例39个瘤灶残留,7例新发病灶,其中2例单发,5例多发,共13个新发病灶。残留灶与新发灶均表现为局部异常肿瘤血管和肿瘤染色。MRI共显示29例36个残留灶,6例共12个新发病灶;敏感性为92%,特异性为100%。SCT显示共有23例28个残留病灶,显示6例共12个新发病灶;敏感性为72%,特异性为100%。MRI对于肿瘤残留灶的检出率、敏感性高于SCT(P<0.05),对于新发病灶两者差异无统计学意义(P>0.05)。结论与SCT比较,MRI能排除碘油沉积的影响,更加敏感地检测出肿瘤的残留、复发及新发病灶,而且更能反映肿瘤TACE治疗后的病理改变。

Objective To study the value of MRI and SCT examinations Compared with DSA in the follow up of HCC treated with transcatheter hepatic arterial chemoembolization （THAC）. Materials and Methods 31patients with HCC were treated with TACE. All the patients performed MRI and SCT examinations 1 week before and 3 months after TACE therophy, and of DSA examination lweek after MRI and SCT scan. DSA resuhs was regarded as the golden standard. MRI results were compared with SCT to display the HCC. Results DSA found 39 residual viable tumor lesions in 30 patients and 13 new lesions in 7 patients. MRI showed 36 residual viable tumor lesions in 29 patients and 12 new lesions in 6 patients. The sensitivity and specificity of MRI were 92% and 100%. SCT showed 28 residual viable tumor lesions in 23 patients and 12 new lesions in 6 patients. The sensitivity and specificity of SCT were 72% and 100%. Compared with SCT, MRI had higher sensitivity to find the residual viable tumor （ P 〈 0.05 ） and the same sensitivity to find new lesions （ P 〉 0.05 ）. Conclusion Compaired with SCT, MRI can eliminate the influence of iodine deposition and show more details of the residual viable tumor and new lesions of HCC after TACE. MRI should be the first choice in follow up of HCC after TA- CE.