MRI与CT在肝硬化背景下肝脏良恶性结节鉴别诊断中应用价值对比

Comparison of the Application Value of MRI and CT in the Differential Diagnosis of Benign and Malignant Liver Nodules in the Context of Liver Cirrhosis

目的:探究在肝硬化背景下采用磁共振(MRI)及计算机断层扫描(CT)鉴别诊断肝脏良恶性结节的应用价值。方法:回顾性分析2018年9月-2021年7月于某院就诊的肝硬化背景下肝脏结节患者100例的临床资料,所有患者均行MRI及CT检查。以病理结果作为诊断“金标准”,分析MRI及CT检查在肝脏良恶性结节中的检出情况,并分析在肝硬化背景下MRI及CT检查诊断肝脏良恶性结节中的应用价值,另计算MRI及CT检查与病理结果的一致性。结果:MRI及CT在肝癌、海绵状血管瘤、局灶性结节性增生、肝腺瘤检出中比较,差异无统计学意义(P>0.05);MRI检查在肝硬化背景下鉴别诊断肝脏良恶性结节中特异度为92.73%,准确度为95.00%,阳性预测值为91.67%,均高于CT检查的78.18%、83.00%、76.92%,差异有统计学意义(P<0.05);灵敏度及阴性预测值比较,差异无统计学意义(P>0.05);kappa检验显示:MRI与病理检查结果的一致性良好(kappa值=0.900,P=0.000);CT与病理检查结果的一致性尚可(kappa值=0.661,P=0.000)。结论:MRI及CT检查在肝硬化背景下肝脏良恶性结节的鉴别诊断中具有较高的临床应用价值,其中MRI检查具有更高的特异度及准确度,且与病理结果一致性较强,诊断效果更高,可将其作为鉴别诊断的首选方法,值得推广。

Objective:To investigate the application value of magnetic resonance imaging(MRI)and computed tomography(CT)in the differential diagnosis of benign and malignant liver nodules in the context of liver cirrhosis.Methods:The clinical data of 100 patients with liver nodules in the context of liver cirrhosis who were treated in a hospital from September 2018 to July 2021 were retrospectively analyzed.All patients underwent MRI and CT examinations.Using pathological results as the"gold standard"for diagnosis,the detection of MRI and CT in benign and malignant liver nodules was analyzed,and the application value of MRI and CT in the diagnosis of benign and malignant liver nodules in the context of liver cirrhosis was analyzed.The consistency between MRI,CT examinations and pathological findings was calculated.Results:There was no statistically significant difference between MRI and CT in the detection of liver cancer,cavern ous hemangioma,focal nodular hyperplasia and hepatic adenoma(P>0.05).In the MRI examination in the differential diagnosis of benign and malignant liver nodules in the context of cirrhosis,the specificity was 92.73%,the accuracy was 95.00%,and the positive predictive value was 91.67%,which were all higher than those of CT examination(78.18%,83.00%,76.92%),and the differences were statistically significant(P<0.05).There was no statistically significant difference in sensitivity and negative predictive value(P>0.05).kappa test showed that MRI and pathological examination results were in good consistency(kappa value=0.900,P=0.000),and the consistency between CT and pathological examination findings was acceptable(kappa value=0.661,P=0.000).Conclusion:MRI and CT examinations have high clinical application value in the differential diagnosis of benign and malignant liver nodules in the context of liver cirrhosis.MRI examination has higher specificity and accuracy,and is more consistent with pathological results,with higher diagnostic effect,whicht can be used as the preferred method for differential diagnosis,and is worthy of promotion.