原发性肝癌、肝硬化鉴别诊断中CT、MRI的临床应用效果探究

The clinical application effect of CT and MRI in the differential diagnosis of primary liver cancer and liver cirrhosis

目的:比较探究原发性肝癌肝细胞癌(hepatocellular carcinoma,HCC)、肝硬化鉴别诊断中CT、MRI的临床诊断效果。方法:选取2015年7月-2022年8月山东省泰山医院接诊的乙肝背景下超声检查提示肝脏局灶性病变患者149例为研究对象,行对比性研究。受试者病理诊断前均依次接受增强CT、增强MRI检查。以病理诊断结果为金标准或一年以上随诊,比较CT、MRI对HCC、肝硬化临床诊断效果;分析HCC、肝硬化患者CT、MRI诊断中成像参数差异。结果:增强MRI诊断HCC的灵敏度、准确率高于增强CT,差异有统计学意义(P<0.05)。HCC患者增强CT诊断中HPI、HAF、HPF均低于肝硬化患者,差异有统计学意义(P<0.05)。HCC患者增强MRI诊断中T_(1)WI等或高信号检出率均低于肝硬化患者,T_(2)WI、DWI高信号、动脉期强化、门静脉期轮廓清晰及肝胆期低信号检出率均高于肝硬化患者,差异有统计学意义(P<0.05)。结论:针对乙肝背景下肝脏局灶性病变患者开展增强CT或增强MRI诊断,均可实现对病灶性质的有效鉴别诊断,就诊断效果而言,增强MRI诊断中成像参数更为丰富,故具备诊断优势。

Objective To compare the clinical diagnostic performance of CT and MRI in the differential diagnosis of hepatocellular carcinoma(HCC)and liver cirrhosis.Methods A comparative study was conducted on 149 patients with focal liver lesions diagnosed by ultrasound in the context of hepatitis B received by Shandong Taishan Hospital from July 2015 to August 2022.All subjects received enhanced CT and enhanced MRI before pathological diagnosis.The clinical diagnostic effect of CT and MRI on HCC and cirrhosis was compared based on the pathological diagnosis as the gold standard or follow-up for more than one year;To analyze the difference of imaging parameters in CT and MRI diagnosis of HCC and liver cirrhosis.Results The sensitivity and accuracy of enhanced MRI in the diagnosis of HCC were higher than those of enhanced CT,and the difference was statistically significant(P<0.05).The HPI,HAF and HPF in the diagnosis of enhanced CT in patients with primary liver cancer were lower than those in patients with cirrhosis,with statistically significant differences(P<0.05).The peak time,signal enhancement ratio and T_(1)WI or high signal detection rate in enhanced MRI diagnosis of primary liver cancer were lower than those in patients with liver cirrhosis,with statistically significant differences(P<0.05).Conclusion Enhanced CT and enhanced MRI diagnosis can achieve effective differential diagnosis of primary liver cancer and cirrhosis under the background of hepatitis B after analyzing the differences in imaging parameters of different lesion types.