多排螺旋CT与MRI对乙型肝炎肝硬化背景小肝癌检出的比较研究

A Comparative Study of Multi-slice Spiral CT and MRI in Detection of Small Hepatocellular Carcinoma with Liver Cirrhosis Background

目的对比研究多排螺旋CT与磁共振成像（MRI）对乙型肝炎（乙肝）肝硬化背景小肝癌检出的效果。方法回顾性分析河北省唐山市协和医院CT/MR室2012年2月至2014年2月收治的84例共96个病灶的乙肝肝硬化背景小肝癌患者,根据患者肝癌病灶直径大小分为两组：微小肝癌组（≤1 cm）28个病灶;小肝癌组（1~3 cm）68个病灶。给予两组患者多排螺旋CT及MRI检测,对比两组患者小肝癌检出率。结果微小肝癌组检出率最高序列为容积快速三维成像（LAVA）动脉期,最低位LAVA平衡期;而小肝癌组检出率最高序列为LAVA动脉期和CT动脉期,最低为CT平扫,其余期相和序列差异无统计学意义。此外,CT总检出率为89.6%（86/96）,MRI总检测率为97.9%（94/96）,两者比较差异有统计学意义（P〈0.05）。结论 MRI检测在乙肝肝硬化背景小肝癌检出率上具有显著优势,显著高于多排螺旋CT扫描技术,且检出率最高序列为LAVA动脉期。

Objective To compare the effect of multi-slice spiral CT and MRI for detection of small hepatocellular carcinoma（ HCC） with liver cirrhosis of hepatitis B background. Methods A retrospective analysis of 84 cases（ 96 lesions） of small HCC with hepatitis B cirrhosis admitted to CT / MR Room of Hebei Province Tangshan City Xiehe Hospital between Feb. 2012 to Feb. 2014 was done. According to the diameter of liver lesions the patients were divided into two groups： micro HCC group（ ≤ 1 cm） of28 lesions; small HCC group（ 1-3 cm） of 68 lesions. All the patients were given multi-slice spiral CT and MRI detection,and the small HCC detection rate of the two groups was compared. Results The highest detection rate of the sequence of micro HCC group was liver acceleration volume acquisition（ LAVA） arterial phase,the lowest was LAVA balance phase; while the highest detection rate of the sequence of the small HCC group was LAVA arterial phase and CT arterial phase,the lowest was CT scan. There was no significant difference in other phases and sequences. In addition,the total detection rate of CT was89. 6%,of MRI was 97. 9%,and the difference was statistically significant（ P〈0. 05）. Conclusion MRI has a significant advantage in the detection rate of small HCC with HBV cirrhosis background,which is significantly higher than the multi-slice spiral CT scanning technology,and the sequence with the highest detection rate is LAVA arterial phase.