MRI与CT在原发性肝癌TACE术后疗效评估中应用价值对比

Comparison of the Application Value of MRI and CT in the Efficacy Evaluation of Primary Liver Cancer after TACE

目的:对比磁共振成像(MRI)与电子计算机断层扫描(CT)在原发性肝癌(PHC)经导管肝动脉化疗栓塞术(TACE)术后疗效评估中应用价值。方法:选取2018年1月~2020年12月于某院治疗的124例PHC患者为研究对象。124例PHC患者均接受TACE治疗,均采用MRI、CT检查评估TACE术后疗效。统计DSA诊断结果,计算MRI与CT在PHC患者TACE术后病灶残留或复发中的诊断效果。结果:以DSA结果作为最终诊断结果进行评价,124例PHC患者中共有141个病灶,经TACE治疗后56个病灶完全灭活,85个病灶存在残留或复发;MRI诊断结果与DSA结果一致性极好(Kappa=0.913,P=0.000);CT诊断结果与DSA结果一致性较为理想(Kappa=0.682,P=0.000);MRI诊断敏感度(92.94%)、阴性预测值(90.32%)、准确率(95.74%)均高于CT诊断敏感度(72.94%)、阴性预测值(70.89%)、准确率(83.69%),差异有统计学意义(P<0.05)。结论:MRI利于发现TACE术后残存或复发病灶,诊断敏感度、特异度及准确率较高,可为PHC患者TACE术后疗效评估提供更为精准的参考。

Objective:To compare the application value of magnetic resonance imaging(MRI)and computed tomography(CT)in the evaluation of postoperative efficacy of transcatheter arterial chemoembolization(TACE)for primary liver cancer(PHC).Methods:A total of 124 PHC patients who were treated in a hospital from January 2018 to December 2020 were selected.All 124 PHC patients received TACE,and MRI and CT were used to evaluate the postoperative efficacy of TACE.The diagnostic results of DSA were counted,and the diagnostic efficacy of MRI and CT in the residual or recurrence of lesions after TACE in PHC patients was calculated.Results:Using DSA results as the final diagnostic results,124 PHC patients had 141 lesions,56 lesions were completely inactivated after TACE treatment,and 85 lesions were residual or recurrent;The MRI diagnosis results were in excellent agreement with the DSA results(Kappa=0.913,P=0.000).CT diagnostic results were in good agreement with DSA results(Kappa=0.682,P=0.000).The diagnostic sensitivity(92.94%),negative predictive value(90.32%),accuracy(95.74%)of MRI were higher than those of CT(72.94%,70.89%,83.69%),and the difference was statistically significant(P<0.05).Conclusion:MRI is conducive to the discovery of residual or recurrent lesions after TACE,with high diagnostic sensitivity,specificity and accuracy,which can provide a more accurate reference for the postoperative efficacy evaluation of TACE in PHC patients.