磁共振扩散加权成像与螺旋CT分别联合血清AFP对早期原发性肝癌诊断价值的对比分析

Comparison of Magnetic Resonance Diffusion Weighted Imaging and Spiral CT Combined with Serum AFP in Early Diagnosis of Primary Liver Cancer

目的探讨磁共振扩散加权成像与螺旋CT分别联合血清甲胎蛋白(AFP)对早期原发性肝癌的诊断价值。方法选取200例疑似原发性肝癌患者,分别进行磁共振扩散加权成像联合血清AFP检测以及螺旋CT联合血清AFP检测。以组织病理活检为金标准,观察2种检测方式对早期原发性肝癌患者的特异度、灵敏度、阳性预测值、阳性似然比以及诊断准确率。结果经病理检测后,200例疑似原发性肝癌患者中有180例确诊为原发性肝癌患者,DWI+血清AFP对原发性肝癌阳性检出率明显高于CT+血清AFP检测阳性检出率[(90. 56%) vs(82. 22%)(χ~2=5. 315,P=0. 021)],DWI+血清AFP检测特异度明显高于CT+血清AFP检测特异度[(80. 00%) vs(45. 00%)(χ~2=5. 227,P=0. 022)]。DWI+血清AFP检测后对原发性肝癌的特异度、灵敏度、阳性预测值、阳性似然比、诊断准确率分别为80. 00%、90. 56%、97. 60%、4. 78、89. 50%,CT+血清AFP检测后对原发性肝癌的特异度、灵敏度、阳性预测值、阳性似然比、诊断准确率分别为45. 00%、82. 22%、93. 08%、1. 49、78. 50%,DWI+血清AFP检测的各结果明显优于CT+血清AFP检测。结论磁共振扩散加权成像联合血清AFP水平对HCC的临床诊断价值显著高于螺旋CT,其在HCC的早期诊断中具有较高的灵敏度、特异度以及阳性似然度,对HCC早期发病的临床诊断具有重要参考价值。

Objective To compare the diagnostic value of magnetic resonance diffusion weighted imaging and spiral CT combined with serum alpha-fetoprotein(AFP)in the diagnosis of primary liver cancer,and to improve the diagnosis of early primary liver cancer.Methods A total of 200 patients with suspected primary liver cancer were enrolled in our hospital from January 2014 to February 2016.The patients were examined by magnetic resonance diffusion weighted imaging combined with serum AFP and spiral CT combined with serum AFP.Compared with the gold standard,two kinds of detection methods were observed for early primary liver cancer Patient specificity,sensitivity,positive predictive value,positive likelihood ratio,and diagnostic accuracy.Results The positive rate of AFP in DWI+serum was significantly higher than that in patients with primary hepatocellular carcinoma(P<0.05).The positive rate of AFP in DWI+serum was significantly higher than that in CT+serum(P<0.05)(80.2%)(χ2=5.315,P=0.021)],the specificity of DWI+serum AFP was significantly higher than that of CT+serum AFP[(80.00%)vs(45.00%)(χ2=5.227,P=0.022).The specificity,sensitivity,positive predictive value and positive likelihood ratio of DWI+serum AFP were 80.00%,90.56%,97.60%,4.78,89.50%,CT+serum AFP The specificity,sensitivity,positive predictive value and positive likelihood ratio of the primary hepatocellular carcinoma were 45.00%,82.22%,93.08%,1.49 and 78.50%respectively.The results of DWI+serum AFP were significantly better Detection of CT+serum AFP.Conclusion The clinical diagnostic value of magnetic resonance diffusion weighted imaging combined with serum AFP level in HCC is significantly higher than that in spiral CT,which has high sensitivity,specificity and positive likelihood of the early diagnosis of HCC.Diagnosis has important reference values.