MSCT与MRI在肝癌患者TACE术后治疗疗效评估中的应用研究

MSCT and MRI in curative effect evaluation of TACE for patients with hepatic carcinoma

目的探究多排螺旋CT(MSCT)与磁共振成像(MRI)对肝癌患者经导管动脉化疗栓塞(TACE)治疗后疗效的评估价值。方法选取2019年1月至2021年6月在解放军第九七〇医院接受TACE治疗的原发性肝癌(PHC)患者70例,男女各35例,年龄(50.14±8.34)岁,收集其临床就诊资料,以数字减影血管造影(DSA)和TACE治疗后6个月随访结果为金标准,采用受试者工作特征曲线(ROC)对比探究MSCT与MRI对TACE疗效的评估精确度。统计学方法采用χ^(2)检验、Z检验。结果DSA检测和随访结果显示,70例患者有61个肿瘤残余或复发病灶,37个病灶无残留或复发。MSCT检测显示43个肿瘤残留或复发病灶、无残留或复发病灶55个,检测灵敏度67.21%、特异度94.59%。MRI检测显示55个肿瘤残留或复发病灶、43个无复发或残留病灶,灵敏度、特异度分别为90.16%、100.00%,MRI的检测灵敏度高于MSCT(P<0.05)。MSCT、MRI分别检出4个、11个明显肿瘤包膜病灶,MRI肿瘤包膜检出率高于MSCT。ROC分析显示,MRI检测TACE治疗疗效的曲线下面积(AUC)为0.951,大于MSCT的0.809。结论MSCT和MRI均能评估肝癌患者TACE治疗疗效,但MRI对复发/残留病灶、肿瘤包膜更为敏感,具有更高的评估价值。

Objective To explore the value of multi-slice spiral CT(MSCT)and magnetic resonance imaging(MRI)in evaluating the curative effect of transcatheter arterial chemoembolization(TACE)for patients with hepatic carcinoma.Methods Seventy patients with primary hepatic carcinoma(PHC)who underwent TACE in 970th Hospital of People,Liberation Army between January 2019 and June 2021 were selected,including 35 males and 35 females who were(50.14±8.34)years old.There clinical data were collected.The digital subtraction angiography(DSA)and 6-month follow-up results after TACE were taken as the golden standard.The receiver operating characteristic curve(ROC)was used to compared the accuracies of MSCT and MRI in evaluating the curative effect of TACE.χ^(2) and Z tests were applied.Results The DSA and follow-up results showed that there were 61 residual or recurrent lesions and 37 non-residual or-recurrent lesions in the 70 patients.MSCT showed 43 residual or recurrent lesions and 55 non-residual or-recurrent lesions,with a sensitivity of 67.21%and a specificity of 94.59%.MRI showed 55 residual or recurrent lesions and 43 non-residual or-recurrent lesions,with a sensitivity of 90.16%and a specificity of 100.00%.The sensitivity of MRI was higher than that of MSCT(P<0.05).Four lesions with obvious tumor capsules were detected by MSCT,and 11 by MRI.The detection rate of tumor capsules by MRI was higher than that by MSCT(P<0.05).The ROC analysis showed that the area under the curve(AUC)of MRI in evaluating the curative effect of TACE was greater than that of MSCT(0.951 vs.0.809;P<0.05).Conclusion Both MSCT and MRI can be used to evaluate the curative effect of TACE for patients with hepatic carcinoma.However,MRI is more sensitive to recurrent/residual lesions and tumor capsules,so it has higher evaluation value.