多层螺旋CT与核磁共振在原发性肝癌介入术后病灶残留及复发中的应用价值

Application Values of Multi-slice spiral CT and Magnetic Resonance Imaging in the Lesion Residues and Recurrence after Primary Hepatic Carcinoma after Interventional Therapy

目的探讨多层螺旋CT与核磁共振（Magnetic Resonance Imaging，MRI）在原发性肝癌（Primary hepatic carcinoma，PHC）介入术后病灶残留及复发中的应用价值。方法选取本院2015年6月-2017年6月收治的PHc患者60例为研究对象，共84个病灶，患者均在行经导管肝动脉化疗栓塞术（transarterial chemoembolization，TACE）后2—6个月来院复查，采用多层螺旋CT、MRI和数字减影血管造影（Digital Subtraction Angiography，DSA）检查。以DSA为金标准，比较多层螺旋CT和MRI检查对术后病灶残留、复发诊断的准确度、敏感度、特异度，以及对病灶肿瘤包膜的检出率。结梁多层螺旋CT病灶残留或复发诊断准确度、敏感度、特异度分别为79．76％、72．58％和100．00％，MRI病灶残留或复发诊断准确度、敏感度、特异度分别为94．05％、91．94％和100．00％，MRI诊断的准确度和敏感度显著高于多层螺旋CT（P〈0．05）：多层螺旋CT肿瘤包膜检出率为3．57％，显著低于MRl肿瘤包膜检出率10．71％（P〈0．05）。结论MRI对于PHC患者TACE术后疗效诊断准确度高，明显优于多层螺旋CT诊断。

Objective To explore the application values of multi-slice spiral CT and magnetic resonance imaging （MRI） in the lesion residues and recurrence of primary hepatic carcinoma （PHC） intervention. Met.hods 60 cases of PHC patients treated in our hospital from June 2015 to June 2017 were selected for the study with a total of 84 lesions, and all the patients were given the review at 2-6 months after the transarterial chemoembolization （TACE）. The multi-slice spiral CT, MRI and digital subtraction angiography （DSA） were performed. The accuracy, sensitivity, specificity of the lesion residues and recurrence and the detection rate of the lesion minor capsule were analyzed by the multi-slice spiral CT and MRI examination taking the DSA as the gold standard. Results The accuracy, sensitivity and specificity of lesion residues and recurrence were 79.76%, 72.58% and 100.00% respectively by the multi-slice spiral CT and were 94.05%, 91.94% 100.00% by MRI, and the accuracy and sensitivity of MRI diagnosis were significantly higher than those by multi-slice spiral CT （P〈0.05）. The detection rate of the lesion tumor capsule by multi-slice spiral CT was significantly lower than that by MRI （3.57% vs 10.71%） （P〈0.05）. Conclusion MRI has the high accuracy of efficacy diagnosis for PHC patients after TACE, which is significantly better than the multi-slice spiral CT diagnosis.