CT和MRI对肝癌介入手术患者术后肿瘤活性的判定价值

The Value of CT and MRI in the Evaluation of Postoperative Tumor Activity in Patients with Hepatocellular Carcinoma After Interventional Surgery

目的探讨CT和MRI对肝癌介入手术患者术后肿瘤活性评估价值。方法选取2015年1月~2017年12月我院125例经穿刺病理确诊的肝癌患者作为研究对象,所有患者经介入手术术后3~5周行CT、MRI及DSA检查,以数字减影血管造影(DSA)检查结果为金标准,比较CT和MRI对肝癌介入术后肿瘤活性评估价值。结果 CT、MRI活性病灶检出率明显低于DSA,CT活性病灶检出率低于MRI,差异具有统计学意义(P<0.05);DSA敏感性、准确率明显高于CT、MRI,MRI敏感性、准确率明显高于CT,差异具有统计学意义(P<0.05)。CT与MRI特异性相同。CT与MRI显示TACE术后肿瘤包膜病灶多于DSA,CT显示TACE术后肿瘤包膜病灶多于MRI,差异具有统计学意义(P<0.05)。结论 MRI在肝癌介入术后肿瘤活性评估中的价值明显高于CT,CT在肿瘤包膜显示上稍有优势,二者联合可以优势互补,提高诊断效能。

Objective To investigate the value of CT and MRI in the evaluation of activity in patients with hepatocellular carcinoma after interventional surgery. Methods A total of 125 patients with biopsy confirmed hepatocellular carcinoma who admitted to our hospital between January 2015 and December 2017 were treated with interventional surgery for 3~5 weeks after operation. All patients underwent CT, MRI and DSA examinations 3~5 weeks after interventional surgery, and the results of digital subtraction angiography(DSA) were used as the gold standard to compare the evaluation value of CT and MRI in tumor activity after interventional surgery of liver cancer. Results The detection rate of CT and MRI active lesions was significantly lower than that of DSA, and the detection rate of CT was lower than that of MRI, with statistically significant differences(P<0.05). The sensitivity and accuracy of DSA were significantly higher than that of CT and MRI, and the sensitivity and accuracy of MRI were significantly higher than that of CT, with statistically significant differences(P<0.05). CT has the same specificity as MRI. CT and MRI demonstrated more tumor enveloped lesions after TACE than DSA, while CT showed more tumor enveloped lesions than MRI, and the difference was statistically significant. Conclusion The value of MRI in the evaluation of tumor activity after interventional surgery of hepatocellular carcinoma is significantly higher than that of CT, which has a slight advantage in tumor envelope display. The combination of the two methods can complement each other and improve the diagnostic efficiency.