CT增强与MRI特异性对比剂增强在肝癌诊断中的价值比较  

Comparison of the value of CT enhancement and MRI specific contrast enhancement in the diagnosis of hepatocellular carcinoma

作　　者：吴英宁[1] 黄莉娜 马德智[1] 李保生[1] 吴为民[1] WU Yingning;HUANG Lina;MA Dezhi;LI Baosheng;WU Weimin(Radiology Department,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)

机构地区：[1]右江民族医学院附属医院放射科,广西百色533000

出　　处：《右江医学》2020年第10期745-750,共6页Chinese Youjiang Medical Journal

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016415)。

摘　　要：目的比较CT增强与MRI特异性对比剂增强对肝癌(HCC)的诊断价值。方法回顾性分析经手术病理证实的肝癌患者64例,将其CT平扫及增强诊断结果、MRI平扫及特异性对比剂增强诊断结果分别与病理结果对照分析,比较两者对肝癌的诊断效能。结果 64例HCC患者共92个病灶中,病理证实HCC病灶84个,MRI特异性对比剂增强诊断HCC的灵敏度为92.85%,特异度为75.00%,诊断符合率为91.30%,CT增强诊断HCC的灵敏度为80.95%,特异度为62.50%,诊断符合率为79.35%,MRI特异性对比剂增强对HCC的灵敏度和诊断符合率均高于CT增强,差异有统计学意义(P<0.05),92个病灶中,直径≤3 cm者51个,其中确认为小肝癌(sHCC)43个,MRI特异性对比剂增强诊断sHCC的灵敏度为97.67%,特异度为75.00%,诊断符合率为94.12%,CT增强诊断sHCC的灵敏度为72.09%,特异度为50.00%,诊断符合率为66.62%,MRI特异性对比剂增强对sHCC的灵敏度和诊断符合率均高于CT增强,差异有统计学意义(P<0.001)。结论相比CT增强扫描,MRI特异性对比剂增强可明显提高HCC、sHCC的灵敏度及诊断符合率。Objective To compare the diagnostic value of computed tomography(CT)enhancement and magnetic resonance imaging(MRI)specific contrast enhancement in the diagnosis of hepatocellular carcinoma(HCC).Methods 64 patients with HCC confirmed by operation and pathology were analyzed retrospectively.The results of plain and enhanced CT scan,MRI plain scan and specific contrast enhancement were respectively compared with pathological results,and the diagnostic efficacy of the two methods in the diagnosis of HCC was compared.Results Of the 92 lesions in 64 patients with HCC,84 were confirmed by pathology.The sensitivity,specificity and diagnostic coincidence rate of MRI specific contrast agent enhancement in the diagnosis of HCC were 92.85%,75.00%and 91.30%,respectively.The sensitivity,specificity and diagnostic coincidence rate of CT enhancement in the diagnosis of HCC were 80.95%,62.50%and 79.35%,respectively.The sensitivity and diagnostic coincidence rate of MRI specific contrast enhancement to HCC were higher than those of CT enhancement,and the difference was statistically significant(P<0.05).Of the 92 lesions,51 lesions were less than or equal to 3 cm in diameter,including 43 small hepatocellular carcinoma(sHCC).The sensitivity and specificity of MRI specific contrast enhancement in the diagnosis of sHCC were 97.67%and 75.00%,respectively,and the diagnostic coincidence rate was 94.12%.The sensitivity and specificity of CT enhancement in the diagnosis of sHCC were 72.09%and 50.00%,respectively,and the diagnostic coincidence rate was 66.62%.The sensitivity and diagnostic coincidence rate of sHCC with MRI specific contrast enhancement were higher than that with CT enhancement,and difference was statistically significant(P<0.001).Conclusion Compared with CT enhanced scan,MRI specific contrast agent enhancement can significantly improve the sensitivity and diagnostic coincidence rate of HCC and sHCC.

关 键 词：计算机体层摄影 钆塞酸二钠 磁共振成像 肝细胞癌 

分 类 号：R735.7[医药卫生—肿瘤] R445[医药卫生—临床医学]