MRI与CT多期动态增强扫描对肝硬化伴肝癌的诊断价值比较

Comparison of MRI and multiphasic dynamic CT with contrast in the diagnosis of liver cirrhosis complicated by liver cancer

目的比较磁共振成像(MRI)与CT对肝硬化伴肝癌的诊断价值。方法抽取2020年5月至2021年5月周口市中心医院收治的肝硬化伴肝癌患者90例,所有患者临床资料均完整,并经病理检查确诊,均接受MRI、CT多期动态增强扫描。对两种检查方式的扫描图像进行评估,比较其诊断效果。结果 90例患者经病理检查共检出病灶99个,CT诊断检出率为91.92%(91/99),MRI诊断检出率为94.95%(94/99),两者比较差异未见统计学意义(P>0.05);CT诊断肝硬化伴肝癌的动脉期、门脉期、延迟期检出率比较差异未见统计学意义(P>0.05);MRI诊断肝硬化伴肝癌的动脉期(90.91%,90/99)与延迟期(86.87%,86/99)检出率高于门脉期(49.49%,49/99),差异有统计学意义(P<0.05);CT诊断的门脉期检出率(74.75%,74/99)与MRI诊断的门脉期检出率(49.49%,49/99)比较差异有统计学意义(P<0.05);而动脉期检出率、延迟期检出率与MRI诊断比较差异均未见统计学意义(P均>0.05)。CT诊断肝硬化伴肝癌患者动脉期-门脉期-延迟期高-低-低、高-等-低信号检出率(58.58%,58/99;10.10%,10/99)与MRI诊断(36.36%,36/99;30.30%,30/99)比较差异有统计学意义(P<0.05);但两者其余信号情况比较,差异未见统计学意义(P>0.05)。结论 MRI与CT对肝硬化伴肝癌患者的诊断价值均较高,但MRI可多方位、多角度扫描,能更好地显示血供特点。

Objective To compare the value of magnetic resonance imaging(MRI)and computed tomography(CT)in the diagnosis of liver cirrhosis complicated by liver cancer.Methods A total of 90 patients with liver cirrhosis complicated by liver cancer admitted to Zhoukou Central Hospital from May 2020 to May 2021 were selected.All selected patients had complete clinical data,and were confirmed by pathological examination.And they received MRI and multiphasic dynamic CT with contrast.The scanning images of the two examination methods were evaluated,and their diagnostic effects were compared.Results Ninety-nine lesions were diagnosed by pathology in the 90 patients;the detection rate of CT was 91.92%(91/99),and the detection rate of MRI was 94.95%(94/99),however,there was no significant difference between CT and MRI(P>0.05).There was no significant difference in the detection rate of liver cirrhosis complicated by liver cancer in arterial phase,portal phase and delayed phase by CT(P>0.05).The detection rate of liver cirrhosis complicated by liver cancer in arterial phase(90.91%,90/99)and delayed phase(86.87%,86/99)detected by MRI were higher than that in portal phase(49.49%,49/99),and the difference was statistically significant(P<0.05).There were significant differences in the detection rate of portal vein phase between CT(74.75%,4/99)and MRI(49.49%,49/99),P<0.05;but there was no significant difference in the detection rate of arterial phase and delayed phase between CT and MRI(all P>0.05).The detection rate of high-low-low and high-iso-low signal in arterial-portal venous-delayed phase of patients with liver cirrhosis diagnosed by CT(58.58%,58/99;10.10%,10/99)were significantly different from those by MRI(36.36%,36/99;30.30%,30/99),P<0.05;however,there was no significant difference between CT and MRI in other signal conditions(P>0.05).Conclusions MRI and CT are of high diagnostic value for patients with liver cirrhosis complicated by liver cancer;however,MRI can scan in multiple directions and angles,and can better display the characteristics of blood supply.