MRI对老年乙肝肝硬化背景小肝癌增强效应的运用分析

Enhancement effectiveness of MRI for the detection of small hepatocellular carcinoma in elderly patients with HBV cirrhosis

目的探讨磁共振成像(MRI)对老年乙肝肝硬化背景小肝癌增强效应的诊断运用。方法选取2014年2月至2016年1月间四川省宜宾市第二人民医院收治的120例老年乙肝肝硬化患者,共138个小肝癌病灶。所有患者均行CT和MRI动态增强扫描,检测记录动脉期强化方式、病灶大小、病灶数目和包膜等情况,比较CT和MRI动脉期与延迟期病灶密度。结果 MRI与CT动脉期强化方式比较,差异无统计学意义(P>0.05)。MRI动脉期与延迟期等级评分均显著高于CT等级评分,差异均有统计学意义(均P<0.05)。CT检测假包膜显示率为40.58%,而MRI为72.46%,差异有统计学意义(P<0.05)。在诊断准确率上CT和MRI分别为93.48%和94.93%,差异无统计学意义(P>0.05)。结论 MRI相比CT法在小肝癌动脉期快速强化特征及假包膜检测敏感率上更高,MRI动态增强扫描较平扫能提高小肝癌的定性准确率。

Objective To analyze the enhancement effectiveness of magnetic resonance imaging（ MRI） in the diagnosis of small hepatocellular carcinoma（ HCC） in elderly patients with cirrhosis caused by hepatitis B virus（ HBV）. Methods One hundred and twenty elderly HBV patients with cirrhosis were selected in Second People＇s Hospital of Yibin City from February 2014 to January 2016,with 138 small HCC nodes detected. All patients underwent CT and MRI dynamic enhancement scanning. Two radiologists read the photographic film,detected and recorded the pattern of enhancement in the arterial phase,nodes size,number of nodes and capsule and compare the density of nodes in arterial and delayed phase between CT and MRI. Results There was no significant difference in the pattern of enhancement in the arterial phase between MRI and CT（ P 0. 05）. The score of arterial phase MRI grade was significantly higher than that that of CT. The score of delayed phase CT grade was significantly lower than that of MRI（ P 0. 05）. The rate of pseudocapsule was 40. 58% for CT and 72. 46% for MRI（ P 0. 05）. The diagnostic accuracy of CT and MRI was 93. 48% and 94. 93%,respectively,with no significant difference（ P 0. 05）. Conclusion MRI showed a higher sensitivity in the dection of characteristics of rapid enhancement of small HCC and pseudocapsule in the arterial phase. MRI dynamic enhanced scanning could improve the qualitative accuracy of small HCC compared with plain scanning.