DWI碘油CT和DSA对复发性肝癌的影像学评估价值比较  

The comparison of imaging evaluation of recurrent hepatocellular carcinoma of DWI,lipiodol-CT and DSA

作　　者：李立[1] 吴晶涛[2] 刘丽[1] 陈新国[1] 吴正宇[1] 

机构地区：[1]靖江市人民医院,江苏靖江214500 [2]苏北人民医院,江苏扬州225001

出　　处：《基层医学论坛》2015年第31期4326-4329,共4页The Medical Forum

摘　　要：目的比较MRI弥散加权成像(DWI)、碘油CT和数字减影血管造影(DSA)对复发性肝癌的检出能力。方法 50例肝癌切除术后确诊肝癌复发者,均行MRI DWI、DSA和碘油CT,分别由2位专家独立判读,分析三种影像学方法检出病灶总的准确度;然后依病灶直径分为3组:A组,<5 mm;B组,5 mm^30 mm;C组,>30mm,统计对不同大小病灶的检出率。结果 50例患者共检出239个病灶,其中DWI、DSA及碘油CT分别检出154,196及226个,漏诊分别为85,43及13个,准确度分别为64.4%,82.0%及94.6%,差异有统计学意义(P<0.05)。<5 mm病灶,DWI检出率50.9%(89/175),DSA检出率77.1%(135/175),碘油CT检出率96.6%(169/175),组间差异有统计学意义(P<0.05)。5 mm^30 mm病灶,DWI、DSA及碘油CT检出率分别为98.0%(51/52)、90.4%(47/52)及90.4%(47/52)(P>0.05);>30 mm病灶,DWI、DSA及碘油CT检出率分别为100%(12/12)、83.3%(10/12)及75%(9/12)(P>0.05)。结论碘油CT诊断肝癌复发准确度最高,尤其对于微小病灶(<5 mm)检出率高;DSA次之;MRI DWI对中大病灶检出率高,微小病灶检出需与其他方法联合使用以提高敏感性。Objective To compare the efficacy of MRI diffusion-weighted imaging,lipiodol-CT and digital substract angiography（DSA）in the diagnosis of recurrent hepatocellular carcinoma（HCC）.Methods A total of 50 cases of recurrent HCC after resection were performed with MRI DWI,DSA and lipiodol-CT. Two experts evaluated all data independently. The sensitivity of three imaging methods was analyzed. Recurrent lesions were divided into three groups：Group A（with diameter 〈5mm）,Group B（5-30mm）and Group C（〉30mm）,then detection rate of different size of recurrent HCC was evaluated respectively. Results 239 lesions were found in 50 cases.DWI,DSA and lipidol-CT detected 154,196 and 226 lesions respectively with 85,43 and 13 lost,and their sensitivity was 64.4 %,82.0% and94.6% respectively（P〈0.05）.The detection rate of DWI,DSA and lipiodol-CT was 50.9%（89/175）,77.1%（135/175）and96.6%（169/175）respectively in Group A（P〈0.05）; 98.0%（51/52）,90.4%（47/52）and 90.4%（47/52）in Group B（P〉0.05）; 100%（12/12）,83.3%（10/12）and 75%（9/12）in Group C（P〈0.05）.Conclusion Lipiodol CT has highest sensitivity in detection of recurrent HCC,especially for small tumor（〈5 mm）;The second is DSA;The detection rate of DWI is high for large lesions which needs a combination of other imaging methods to improve sensitivity for small tumor.

关 键 词：肝细胞癌 复发 数字减影血管造影 碘油CT MRI弥散加权成像 

分 类 号：R735.7[医药卫生—肿瘤]