肝硬化癌变患者的MRI和CT表现及使用介入治疗期间应用影像学分析对改善疗效的临床效果

MRI and CT findings of patients with cirrhosis and cancer and the clinical effect of using imaging analysis to improve the curative effect during interventional therapy

目的分析探讨肝硬化癌变患者的MRI和CT表现以及介入治疗期间应用影像学技术对改善疗效的临床效果,为提高肝硬化癌变诊断与介入治疗水平提供参考。方法研究对象随机选取2010年1月至2019年1月在本院接受治疗的138例肝硬化癌变患者,经病理学证实癌变病灶165个。观察MRI和CT扫描影像学表现特征,收集诊断结果。结果CT扫描共检出肝硬化癌变病灶122个,诊断符合率73.94%;MRI扫描共检出肝硬化癌变病灶165个,诊断符合率100.00%,两种检查方法诊断符合率差异有统计学意义(P<0.05)。CT扫描122个病灶中,动脉早期均表现为中等增强;MRI扫描165个病灶中,T1WI像:110个病灶呈略低信号、55个病灶呈略高信号,T2WI像:124个病灶呈高信号,增强动脉扫描可见动脉期124个病灶呈中度强化,41个病灶小结节样强化;138例肝硬化癌变患者中98例表现为甲胎蛋白(AFP)升高,结合影像学诊断结果实施介入治疗。结论MRI应用于肝硬化癌变检查诊断效果显著优于CT检查,是肝硬化癌变病灶检出的临床首选影像学手段;对于MRI扫描高度提示的癌变患者,应尽早实施介入治疗以保证临床疗效。

Objective To analyze and explore the MRI and CT manifestations of patients with cirrhosis and cancer on one hand and on the other hand the clinical effect of using imaging technology to improve the curative effect during interventional therapy,and to provide references for improving the diagnosis and interventional therapy of cirrhosis and cancer.Methods A total of 138 patients with cirrhosis and cancer who were treated in our hospital from January,2010 to January,2019 were randomly selected,and 165 cancer lesions were confirmed by pathology.The imaging features of MRI and CT scan were observed,and the diagnostic results were collected.Results A total of 122 lesions of cirrhosis were detected by CT scanning,and the diagnostic coincidence rate was 73.94%;a total of 165 lesions of liver cirrhosis were detected by MRI scanning,and the diagnostic coincidence rate was 100.00%;there was a statistical difference in diagnostic coincidence rate between the two examination methods(P<0.05).CT scan showed moderate enhancement of middle artery in the 122 lesions at early stage.Among the 165 lesions,T1WI images showed a slightly low signal in 110 lesions and a slightly high signal in 55 lesions,while T2WI images showed a slightly high signal in 124 lesions.Enhanced arterial scanning showed a moderate enhancement in 124 lesions in the arterial phase and a nodular enhancement in 41 lesions.Among the 138 patients,98 had an increase in fetoprotein(AFP),and took intervention treatment according to the imaging diagnosis results.Conclusion MRI in the diagnosis of liver cirrhosis and cancer is significantly more effective than CT,so it is the first clinical diagnostic choice.For patients with cancer lesions suggested by MRI,early interventional treatment should be adopted to ensure the clinical curative effect.