MSCT、MRI、DSA评价HCC TACE术后复发的价值及对比研究

The value of MSCT,MRI,DSA in the diagnosis of tumor recurrence after hepatocellular carcinoma patients operated by transcatheter arterial chemoembolization

目的:对比分析MSCT、MRI、DSA评价肝癌(HCC)TACE术后复发的价值。方法:HCCTACE术后1月排除HCC病灶残留后,共收集108例HCCTACE术后复发的病例。对其进行临床随访,评价MSCT、MRI和DSA显示HCCTACE术后复发的符合情况。结果:对于①小于0.5cm的复发灶,MSCT与DSA比较其检出率分别为43.5%(40/92)、86.9%(80/92);MSCT与MRI比较其检出率分别为50%(11/22)、90.9%(20/22);MRI与DSA比较其检出率分别为93.1%(27/29)、89.7%(26/29);②对于大于0.5cm小于1cm的复发灶,MSCT与DSA比较其检出率分别为86.5%(45/52)、94.2%(49/52);MSCT与MRI比较其检出率分别为85.0%(17/20)、95.0%(19/20);MRI与DSA比较其检出率分别为100%(24/24)、95.8%(23/24);③对于大于1cm的复发灶,MSCT、MRI和DSA检出率均为100%。结论:①MRI对于显示小于0.5cm的乏血供复发灶比MSCT和DSA敏感,MRI应为首选检查;②DSA显示复发灶的肿瘤染色、血管形态及血管受侵袭情况较MSCT、MRI好;③MSCT显示碘化油聚集的形态较MRI和DSA好;④MRI和DSA显示小于0.5cm的复发灶较MSCT敏感。

Objective： To analyze comparatively the value of MSCT, MRI, DSA in the diagnosis of tumor recurrence after hepatecellular carcinoma patients operated by transcatheter artcrial chemoembolization. Methods： After HCC patients operated by TACE, 108 patients with tumor recurrence were collected by exclusion the residual viable tumor. We evaluated the diagnositic value of MSCT, MR/and DSA in the tumor recurrence of HCC operated by TACE with clinical follow-up results. Results： ① For the lesions in diameter less than 0.5 cm, in MSCT compared with DSA, the detection rate of MSCT was 43.5 % （40/92）, while DSA was 86.9% （80/92）. In MSCT compared with MRI, the detection rate of MSCT was 50% （11/22）, while MR/was 90.9% （20/22）. In Mill compared with DSA, the detection rate of MR/was 93.1%（27/29） while DSA were 89.7% （26/29） ; ② For the lesions more than 0.5 cm and less than 1.0 cm, in MSCT compared with DSA, the detection rate of MSCT was 86.5%（45/52）, while DSA were 94.2%（49/52）. In MSCT compared with Mill, tile detection rate of MSCT was 85.0% （17/20） Mille MRI was 95.0% （19/20）. In MR/compared with DSA, the detection rate was 100% （24/24）for MR/while was 95.8%（23/24） for DSA; ③ For the lesions more than 1.0 cm, the detection rate of lesions were 100% （42/42） for MSCT, MR/and DSA respectively. Conclusion： ①The sensitivity of Mill is superior to that of MSCT, and DSA for appearing lesions with both eack of blood supply and less filan 0.5 cm. So MR/should be first selected; ② DSA is superior to and Mill in some aspects, such as tumor staining and vascular shape;③ The collected iodipin shape appeared by MSCT is superior to MR/and DSA; ④ The sensitivity of MR/and DSA is superior to that of MSCT for appearing lesions with less than 0.5 cm.