MRI多序列成像在肝硬化背景下小肝癌诊断和微血管侵犯评估中的应用价值

Application Value of MRI Multi-sequence Imaging in the Diagnosis of Small Liver Cancer and Evaluation of Microvascular Invasion in Cirrhosis

目的探讨MRI多序列成像在肝硬化背景下小肝癌诊断和微血管侵犯评估中的应用价值。方法选择2020年9月~2022年9月在我院接受诊断的80例疑似小肝癌的患者为研究对象,均采用西门子3.0 T Verio超导型磁共振扫描仪检查,分析MRI多序列成像对肝硬化背景下小肝癌诊断和微血管侵犯评估中的应用价值,以肝脏穿刺活检为金标准,采用Kappa一致性检验,分析MRI多序列成像在小肝癌诊断和微血管侵犯的一致性。结果80例疑似小肝癌患者经病理确诊36例,未发生肝癌44例。T2WI诊断敏感度为83.33%,特异度为79.55%,准确度为81.25%,Kappa值为0.624;T1WI诊断敏感度为77.78%,特异度为81.82%,准确度为80.00%,,Kappa值为0.596;LAVA诊断敏感度为83.33%,特异度为81.82%,准确度为82.50%,Kappa值为0.648;联合诊断敏感度为94.44%,特异度为77.27%,准确度为85.00%,Kappa值为0.703。36例疑似小肝癌患者经病理确诊MVI 7例,未发生MVI 29例。T2WI诊断敏感度为71.43%,特异度为86.21%,准确度为83.33%,Kappa值为0.520;T1WI诊断敏感度为71.43%,特异度为82.76%,准确度为80.56%,Kappa值为0.466;LAVA诊断敏感度为71.43%,特异度为89.66%,准确度为86.11%,Kappa值为0.579;联合诊断敏感度为85.71%,特异度为82.76%,准确度为83.33%,Kappa值为0.563。结论MRI多序列成像有助于提高肝硬化背景下小肝癌的诊断和微血管侵犯的评估,具有良好的应用价值。

Objective To explore the application value of MRI multi-sequence imaging in the diagnosis of small liver cancer and evaluation of microvascular invasion(MVI)in cirrhosis.Methods A total of 80 patients with suspected small liver cancer in the hospital were enrolled as the research objects between September 2020 and September 2022.All were examined by Siemens 3.0T Verio superconducting magnetic resonance scanner to analyze the application value of MRI multi-sequence imaging in the diagnosis of small liver cancer and evaluation of MVI in cirrhosis.Taking liver puncture biopsy as the golden standard,the consistency of MRI multi-sequence imaging in the diagnosis of small liver cancer and MVI was analyzed by Kappa consistency test.Results In the 80 patients with suspected small liver cancer,pathological diagnosis showed that there were 36 cases with small liver cancer and 44 cases without.The diagnostic sensitivity,specificity,accuracy and Kappa value of T2WI,T1WI,LAVA and combined detection were(83.33%,79.55%,81.25%,0.624),(77.78%,81.82%,80.00%,0.596),(83.33%,81.82%,82.50%,0.648)and(94.44%,77.27%,85.00%,0.703),respectively.In the 36 patients with suspected small liver cancer,pathological diagnosis showed that there were 7 cases with MVI and 29 cases without.T2WI.The diagnostic sensitivity,specificity,accuracy and Kappa value of T2WI,T1WI,LAVA and combined detection were(71.43%,86.21%,83.33%,0.520),(71.43%,82.76%,80.56%,0.466),(71.43%,89.66%,86.11%,0.579)and(85.71%,82.76%,83.33%,0.563),respectively.Conclusion MRI multi-sequence imaging is beneficial to improve the diagnosis of small liver cancer and evaluation of MVI in cirrhosis.