原发性肝细胞癌患者多层螺旋CT及MRI临床诊断价值分析

Diagnostic Values of Multi-slice Spiral CT and MRI in Patients with Primary Hepatocellular Carcinoma

目的探讨多层螺旋CT及磁共振成像(MRI)在原发性肝细胞癌(HCC)诊断中的临床价值。方法回顾性分析我院收治的106例HCC患者多层螺旋CT和MRI影像资料,并与病理检查结果进行对照。结果CT共发现101个癌灶,其中58个癌灶表现为动脉期明显强化,门静脉期强化减退,平衡期呈低密度表现;23个癌灶在动脉期呈低密度,门静脉期和平衡期呈稍高密度;20个癌灶在增强扫描后始终较背景肝呈稍低密度。MRI共发现112个癌灶,增强扫描69个癌灶表现为典型的“快进快出”;29个癌灶在动脉期无明显强化,门静脉期和平衡期呈稍高信号;14个癌灶各期均未见明显强化。CT检测直径>3cm癌灶的检出率明显高于≤3cm癌灶,而MRI各系列对两者的检出率均较高;CT检出85例HCC,准确率为80.19%;MRI检出96例HCC,准确率为90.57%。MRI诊断HCC的准确率明显高于CT(χ2=4.57,P<0.05)。结论在HCC诊断中,MRI对HCC及小HCC癌灶的检出率均高于CT。

Objective To explore the clinical values of multi-slice spiral CT and magnetic resonance imaging(MRI)in the diagnosis of primary hepatocellular carcinoma(HCC).Methods The examination data of multi-slice spiral CT and MRI of 106 cases of HCC patients treated in our hospital were analyzed retrospectively,and compared with the pathological examination results.Results There were 101 lesions found in CT,of which 58 lesions were rapidly enhanced in the arterial phase,decreased in the portal venous phase and demonstrated as low density in the delayed phase.There were 23 lesions presented as low density in arterial phase and slightly high density in portal venous phase and delayed phase.Twenty lesions remained slightly less dense than the background liver after contrastenhanced scan.A total of 112 cancer foci were found on MRI,and 69 lesions with typical"wash in and wash out"on contrast-enhanced scan.Other 29 lesions showed no obvious enhancement in arterial phase,but showed slightly higher signal in portal venous phase and delayed phase.No significant enhancement was observed in 14 cancer foci at each stage.CT showed significantly higher detection rate for tumors with diameter greater than 3 cm than those with diameter less than 3 cm,but both detection rate of CT were lower than MRI.CT detected 85 HCC lesions with an accuracy rate of 80.19%.MRI detected 96 lesions with an accuracy rate of 90.57%.The accuracy rate of HCC diagnosis by MRI was significantly higher than that by CT(χ2=4.57,P<0.05).Conclusion In the diagnosis of HCC,the detection rate of MRI for HCC and small HCC lesions are higher than that of CT.