MR多序列联合钆塞酸二钠增强扫描对肝硬化并TACE术后复发微小病灶诊断的研究

Study on the Diagnosis of Recurrent Small Lesions after TACE in Patients with Liver Cirrhosis by MR Multiple Sequences Combined with Gadolinate Disodium Enhanced Scanning

目的:探讨磁共振(MR)多序列联合钆塞酸二钠(Gd-EOB-DTPA)增强扫描对肝硬化并肝癌肝动脉化疗栓塞术(TACE)术后复发微小病灶诊断应用的研究。方法:回顾性分析2021年6月至2022年7月信丰县人民医院收治的50例肝硬化并肝癌TACE术后患者临床资料。所有患者分别采用DSA造影、CT增强、MR多序列联合Gd-EOB-DTPA增强扫描定期复查。分析比较CT增强、MR多序列联合Gd-EOB-DTPA增强扫描的病灶数目、大小、包膜诊断价值。结果:DSA造影显示,50例患者中共发现61个病灶,直径0.5~2.0 cm,平均(1.25±0.74) cm,54个证实为复发小肝癌,7个病灶为非肝癌病灶,均经6个月随访时间证实,复发小肝癌中35个有病理结果,其余19个均经随访证实;CT增强发现50个复发小肝癌,8个包膜病灶;MR多序列联合Gd-EOB-DTPA增强扫描发现51个复发小肝癌,21个包膜病灶;MR多序列联合Gd-EOB-DTPA增强扫描包膜病灶检出率、特异度、阳性预测值、阴性预测值、准确度均高于CT增强检测(P<0.05)。结论:MR多序列联合Gd-EOB-DTPA增强扫描在肝硬化并肝癌TACE术后复发微小病灶中具有较高的诊断价值。

Objective:To investigate the application of magnetic resonance(MR) multi sequence combined with gadolinium disulfide(Gd-EOB-DTPA) enhanced scanning in the diagnosis of recurrent small lesions after transcatheter arterial chemoembolization(TACE) for liver cirrhosis complicated with liver cancer.Methods:The clinical data of 50 patients with liver cirrhosis and liver cancer after TACE from June 2021 to July 2022 in the People's Hospital of Xinfeng County were retrospectively analyzed.All patients underwent regular follow-up examinations using DSA imaging,CT enhanced,and MR multi sequence combined with Gd-EOB-DTPA enhanced scan.Analyzed and compared the number,size and capsule diagnostic value of CT enhanced,MR multi sequence combined with Gd-EOB-DTPA enhanced scan.Result:DSA imaging showed that a total of 61 lesions were found in 50 patients,with a diameter of 0.5~2.0 cm and an average of (1.25 ± 0.74) cm.54 lesions were confirmed to be recurrent small liver cancer,and 7 lesions were non liver cancer lesions,all confirmed after 6 months of follow-up.Among the recurrent small liver cancer,35 had pathological results,while the remaining 19 were confirmed by follow-up;CT enhancement revealed 50 recurrent small liver cancer and 8 capsule lesions;MR multi sequence combined with Gd-EOB-DTPA enhanced scan revealed 51 recurrent small liver cancer and 21 envelope lesions.The detection rate,specificity,positive predictive value,negative predictive value and accuracy of MR multi sequence combined with Gd-EOB-DTPA enhanced scan for capsule lesions were higher than those of CT enhanced detection(P<0.05).Conclusion:MR multi sequence combined with Gd-EOB-DTPA enhanced scanning has high diagnostic value in the recurrence of small lesions after TACE for liver cirrhosis complicated with liver cancer.