高场强MRI与64排螺旋CT在鉴别诊断肝硬化结节与小肝癌中的应用价值比较

Comparison of Application Value of High-field Intensity MRI and 64-slice Spiral CT in Differential Diagnosis of Cirrhotic Nodules and Small Hepatocellular Carcinoma

目的:探讨高场强磁共振成像(MRI)与64排螺旋电子计算机断层扫描(CT)在鉴别诊断肝硬化结节与小肝癌中的应用价值。方法:前瞻性选取2019年10月-2021年10月丰城市人民医院接收的63例肝硬化伴结节患者,剔除3例患者,最终入组60例。患者均于术前行高场强MRI、64排螺旋CT检查,以病理学结果为“金标准”,比较高场强MRI、64排螺旋CT在鉴别诊断肝硬化结节和小肝癌中的应用价值。将小肝癌视为阳性,肝硬化结节视为阴性。结果:60例肝硬化伴结节患者中,经病理学检查证实小肝癌36例,肝硬化结节24例。经64排螺旋CT检查小肝癌32例,肝硬化结节28例。经高场强MRI检查小肝癌35例,肝硬化结节25例。以病理学结果为“金标准”,高场强MRI诊断小肝癌的准确度、敏感度、阴性预测值均高于64排螺旋CT诊断(P<0.05)。高场强MRI诊断小肝癌的特异度、阳性预测值与64排螺旋CT诊断比较,差异均无统计学意义(P>0.05)。结论:高场强MRI与64排螺旋CT在鉴别诊断肝硬化结节与小肝癌中均具有一定应用价值,但高场强MRI诊断小肝癌的准确度、敏感度及阴性预测值更高。

Objective: To investigate the application value of high-field intensity magnetic resonance imaging(MRI) and 64-slice spiral computed tomography(CT) in differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma. Method: A total of 63 patients with cirrhosis and nodules admitted to Fengcheng People’s Hospital from October 2019 to October 2021 were prospectively included, and 3 patients were excluded, and 60patients were finally included. All patients underwent high-field intensity MRI and 64-slice spiral CT examination before surgery, the pathological results were taken as the "gold standard", the application value of high-field intensity MRI and 64-slice spiral CT in the differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma were compared. Small hepatocellular carcinoma was regarded as positive and cirrhotic nodules as negative. Result: Among the 60 patients with cirrhosis nodules, 36 cases were confirmed by pathological examination as small hepatocellular carcinoma and 24 cases as cirrhosis nodules. 32 cases of small hepatocellular carcinoma and 28 cases of cirrhotic nodules were examined by 64-slice spiral CT. High-field intensity MRI examined 35 cases of small hepatocellular carcinoma and 25 cases of cirrhotic nodules. Using pathological results as the "gold standard", the accuracy,sensitivity in the diagnosis of small hepatocellular carcinoma and negative predictive value of high-field intensity MRI were higher than those of 64-slice spiral CT(P<0.05). There were no significant differences in the specificity and positive predictive value diagnosed by high-field intensity MRI and 64-slice spiral CT(P>0.05). Conclusion: Both highfield intensity MRI and 64-slice spiral CT have certain application value in the differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma, but high-field intensity MRI has higher accuracy, sensitivity of small hepatocellular carcinoma and negative predictive value.