钆塞酸二钠增强MRI对原发性肝癌经导管动脉栓塞化疗后复发微小病灶的诊断价值分析

Diagnostic value of Gd-EOB-DTPA-enhanced MRI in recurrent small lesions of primary liver cancer after transcatheter arterial chemoembolization

目的探讨钆塞酸二钠(gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid,Gd-EOB-DTPA)增强MRI对原发性肝癌经导管动脉栓塞化疗(transcatheter arterial chemoembolization,TACE)后复发微小病灶的诊断价值。方法选取2016年4月至2017年8月本院收治的原发性肝癌患者52例为研究对象,均行TACE治疗,术后随访3个月,所有患者均采用增强CT、Gd-EOB-DTPA增强MRI及数字减影血管造影(digital substraction angiography,DSA)检查,以DSA检查结果作为标准,比较增强CT和Gd-EOB-DTPA增强MRI对患者TACE治疗后复发微小病灶及肿瘤包膜的检出率。结果 Gd-EOB-DTPA增强MRI对TACE治疗后复发微小病灶的诊断准确率和灵敏度均显著高于增强CT(P_均<0.05),但二者的特异度无显著差异(P>0.05)。Gd-EOB-DTPA增强MRI对肿瘤包膜的检出率显著高于增强CT(P <0.05)。结论 Gd-EOB-DTPA增强MRI对原发性肝癌TACE治疗后复发微小病灶的检出能力更强,具有更高的诊断准确率和灵敏度,同时能更有效地显示肿瘤包膜情况。

Objective To explore the diagnostic value of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOBDTPA)-enhanced MRI in recurrent small lesions of primary liver cancer after transcatheter arterial chemoembolization(TACE).Method A total of 52 patients with primary liver cancer treated in our hospital from April 2016 to August 2017 were selected as the subjects of the study,all of them were treated with TACE,followed up for 3 months,all patients were examined by enhanced CT,Gd-EOB-DTPA-enhanced MRI and digital substraction angiography(DSA),DSA was used as the standard to compare the detection rate of recurrent small lesions and capsule after TACE by contrast-enhanced CT and Gd-EOB-DTPA-enhanced MRI.Result The diagnostic accuracy and sensitivity of Gd-EOB-DTPA-enhanced MRI for recurrent small lesions after TACE were significantly higher than those of enhanced CT(Pall<0.05),but there was no significant difference in specificity between the two methods(P>0.05).The detection rate of tumor capsule by Gd-EOB-DTPA-enhanced MRI was significantly higher than that by enhanced CT(P<0.05).Conclusion Gd-EOB-DTPA-enhanced MRI has a stronger ability to detect recurrent small lesions after TACE of primary liver cancer,has higher diagnostic accuracy and sensitivity,and can more effectively display the tumor capsule.