MRI-DWI联合血清学检查在小肝癌诊断中的应用价值  

Application Value of MRI-DWI Combined with Serological Examination in the Diagnosis of Small Hepatoce llular Carcinoma

作　　者：蔡日 游焜[1] 彭亚南 CAI Ri;YOU Kun;PENG Ya-nan(Department of Hepatological Surgery,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院肝胆外科,河南新乡453100

出　　处：《中国CT和MRI杂志》2024年第9期97-99,共3页Chinese Journal of CT and MRI

基　　金：2020年度河南省医学科技攻关计划联合共建项目(LHGJ20200517)。

摘　　要：目的分析磁共振成像-扩散加权成像(MRIDWI)联合血清学检查在小肝癌及诊断中的临床应用价值。方法回顾性分析2021年7月至2023年7月与本院收治的80例小肝癌患者和71例肝局灶性结节增生患者,所有患者均接受MRI-DWI检测,记录两组患者的图像特征,观察并比较两组MRI-DWI检查信号强度值、表观扩散系数(ADC)、甲胎蛋白(AFP)和癌胚抗原(CEA)水平,并采用受试者工作特征(ROC)曲线分析MRI-DWI检查信号强度值、ADC、AFP和CEA及其联合监测对小肝癌的鉴别价值,并分析MRI-DWI参数和血清指标与小肝癌分化程度的相关性。结果小肝癌患者MRI-DWI检查信号表现为强度减弱,病灶往往有不规则的边缘和侵犯周围组织的趋势,肝局灶性结节增生患者MRI-DWI检查典型特征为中心有明显的疤痕,在MRI上表现为低信号。小肝癌组患者的AFP和CEA水平较结节增生组高,信号强度值和ADC值较结节增生组低,差异有统计学意义(P<0.05)。MRI-DWI检查信号强度值、ADC、AFP和CEA联合检查敏感度为83.75%,特异性为98.59%,具有较高诊断价值。高分化组患者的信号强度值、ADC、AFP和CEA水平均较低分化组低,差异有统计学意义(P<0.05),中分化组患者的信号强度值、ADC和CEA水平较低分化组低,差异有统计学意义(P<0.05)。相关性分析显示:MRI-DWI检查信号强度值、ADC、AFP和CEA和患者小肝癌分化程度均呈负相关(P<0.05)。结论MRI-DWI联合血清学检测对小肝癌有较高诊断价值,且小肝癌患者的MRIDWI检查信号强度值、ADC、血清AFP和CEA水平随着患者的分化程度增高而降低。Objective To analyze the clinical application value of magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)combined with serological examination in the diagnosis of small hepatocellular carcinoma(SHCC).Methods A total of 80 patients with SHCC and 71 patients with focal nodular hyperplasia(FNH)in the hospital were retrospectively analyzed between July 2021 and July 2023.All patients underwent MRI-DWI examination to record image characteristics.The signal intensity in MRIDWI examination,apparent diffusion coefficient(ADC),alpha-fetoprotein(AFP)and carcinoembryonic antigen(CEA)in the two groups were observed and compared.The differential value of signal intensity in MRI-DWI examination,ADC,AFP,CEA and combined detection for SHCC was analyzed by receiver operating characteristic(ROC)curves.The correlation between MRI-DWI parameters,serum indexes and differentiation degree of SHCC was analyzed.Results MRI-DWI showed that there was decreased signal intensity,irregular lesions edge and peripheral tissue invasion in patients with SHCC,while there were obvious center scars and low signal on MRI in patients with FNH.The levels of AFP and CEA in SHCC group were higher than those in FNH group,while signal intensity and ADC were lower those that in FNH group(P<0.05).The sensitivity and specificity of signal intensity combined with ADC,AFP and CEA were 83.75%and 98.59%,showing high diagnostic value.The signal intensity,ADC,AFP and CEA in high differentiation group were lower than those in low differentiation group(P<0.05).The signal intensity,ADC and CEA in moderate differentiation group were lower than those in low differentiation group(P<0.05).Correlation analysis showed that signal intensity in MRIDWI examination,ADC,AFP and CEA were negatively correlated with the differentiation degree of SHCC(P<0.05).Conclusion The combined detection of MRI-DWI and serological examination has high diagnostic value for SHCC.With the increase of differentiation degree,signal intensity in MRI-DWI examination,ADC,serum AFP and CEA a

关 键 词：磁共振成像-扩散加权成像 甲胎蛋白 癌胚抗原 分化程度 

分 类 号：R445.2[医药卫生—影像医学与核医学]