探讨多层螺旋CT及MRI在HCC诊断中的临床价值

The clinical value of multi-slice spiral CT and MRI in the diagnosis of HCC

目的观察原发性肝细胞癌(HCC)患者应用多层螺旋CT及磁共振成像(MRI)诊断的价值。方法102例HCC患者,均行多层螺旋CT和MRI检查。将手术病理结果作为金标准,对比多层螺旋CT和MRI对不同病灶直径的检出情况,多层螺旋CT和MRI的阳性检出率。结果102例患者手术病理检出病灶110个,其中病灶直径≥3 cm 81个、<3 cm 29个。多层螺旋CT在平扫、动脉期、门静脉期、平衡期对于病灶直径≥3 cm的检出率高于病灶直径<3 cm的检出率,差异具有统计学意义(P<0.05)。MRI在T1WI、同相位、反相位对于病灶直径≥3 cm的检出率高于病灶直径<3 cm的检出率,差异具有统计学意义(P<0.05);在T2WI、DWI、动脉期、门静脉期、平衡期对于病灶直径≥3 cm的检出率与病灶直径<3 cm的检出率对比,差异无统计学意义(P>0.05)。MRI的阳性检出率90.20%(92/102)高于多层螺旋CT的80.39%(82/102),差异具有统计学意义(P<0.05)。结论多层螺旋CT和MRI在诊断HCC中的临床价值都比较高,但MRI在小病灶诊断中存在一定优势,临床检查中需根据患者具体情况进行科学选择。

Objective To observe the value of multi-slice spiral CT and magnetic resonance imaging(MRI)in the diagnosis of hepatocellular carcinoma(HCC).Methods 102 patients with HCC underwent multi-slice spiral CT and MRI examinations.Taking the surgical pathological results as the gold standard,the detection of different lesion diameters by multi-slice spiral CT and MRI,and the positive detection rate of multi-slice spiral CT and MRI were compared.Results Surgical pathology detected 110 lesions in 102 patients,including 81 lesions≥3 cm in diameter and 29 lesions<3 cm in diameter.The detection rate of multi-slice spiral CT in plain scan,arterial phase,portal vein phase,and equilibrium phase for lesions≥3 cm in diameter was higher than that of lesions<3 cm in diameter,and the difference was statistically significant(P<0.05).The detection rate of MRI on T1WI,in-phase and anti-phase for lesions≥3 cm in diameter was higher than that of lesions<3 cm in diameter,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the detection rate of lesions≥3 cm in diameter in T2WI,DWI,arterial phase,portal venous phase,and equilibrium phase compared with the lesions<3 cm in diameter(P>0.05).The positive detection rate of MRI was 90.20%(92/102),which was higher than 80.39%(82/102)of multi-slice spiral CT,and the difference was statistically significant(P<0.05).Conclusion Both multilayer spiral CT and MRI are of high clinical value in the diagnosis of HCC,but MRI has certain advantages in the diagnosis of small lesions,and the clinical examination needs to be selected scientifically according to the specific conditions of the patients.