增强CT联合增强MRI对结直肠癌患者肝转移的诊断效能  

Diagnostic efficacy of enhanced CT combined with enhanced MRI for liver metastases in patients with colorectal cancer

作　　者：高欢欢 王松太 钱煜佳 崔瑶[2] GAO Huanhuan;WANG Songtai;QIAN Yujia;CUI Yao(Imaging Center,The Traditional Chinese Medicine Hospital of Xinmi City,Xinmi,Henan 452470,China)

机构地区：[1]河南省新密市中医院影像中心,452470 [2]河南省人民医院肿瘤内科,河南郑州473499

出　　处：《淮海医药》2025年第2期126-131,共6页Journal of Huaihai Medicine

基　　金：河南省医学科技攻关计划联合共建项目和软科学项目(LHGJ20210045)。

摘　　要：目的:探讨增强计算机断层扫描(CT)联合增强磁共振成像(MRI)对结直肠癌患者肝转移的诊断效能。方法:选取2022年4月—2024年4月河南新密市中医院收治的80例结直肠癌患者作为研究对象,以病理检查结果为金标准,比较增强CT、增强MRI对结直肠癌患者肝转移诊断的检出率、一致性、敏感度、特异度、准确度及阳性、阴性预测值,以及对不同直径和位置肝转移瘤、结直肠癌原发病灶和肝转移灶分布情况的诊断效能。结果:增强CT、增强MRI联合诊断结直肠癌肝转移检出率与病理检查结果一致性较好(Kappa值为0.882),高于增强CT、增强MRI单独检查(Kappa值分别为0.559、0.766);增强CT、增强MRI联合检查结直肠癌肝转移的灵敏度、特异度、准确度、阳性预测值、阴性预测值(97.84%、88.81%、94.90%、94.77%、95.20%)高于增强CT(89.88%、63.87%、80.10%、80.49%、79.20%)和增强MRI(94.87%、79.86%、89.81%、90.24%、88.80%)单独检测,差异有统计学意义(P<0.05);增强CT、增强MRI联合检查对不同直径和位置的肝转移瘤、左右侧结肠原发病灶和肝转移灶总检出率(97.91%、97.91%、96.25%、98.26%)均高于增强CT(68.29%、64.81%、68.75%、81.85%)和增强MRI(83.28%、82.23%、85.00%、89.20%)单独检查,差异有统计学意义(P<0.05)。结论:增强CT、增强MRI联合检查能更准确地提供结直肠癌肝转移灶的大小、位置分布和转移情况等信息,且具有更高的诊断检出率、灵敏度、特异度及准确度,与病理检查结果一致性好,临床应用诊断价值高于单独检查。Objective:To investigate the diagnostic efficacy of enhanced magnetic resonance imaging(MRI)combined with enhanced computed tomography(CT)on liver metastasis in patients with colorectal cancer.Methods:80 colorectal cancer patients admitted to our hospital from April 2022 to April 2024 were selected as the study subjects.Pathological examination results were used as the gold standard to compare the predictive values of enhanced MRI,enhanced CT or the combination of the two on the diagnostic detection rate,consistency,sensitivity,specificity,accuracy,and positive and negative rates in colorectal cancer patients with liver metastasis,as well as the diagnostic efficacy on liver metastasis tumours of different diameters and locations,distribution of primary colorectal cancer foci and liver metastases,respectively.Results:The detection rate of liver metastasis of colorectal cancer diagnosed by enhanced CT combined with enhanced MRI was in good agreement with the results of pathological examination(Kappa value of 0.882),which was higher than that detected by enhanced CT or enhanced MRI alone(Kappa values of 0.559 and 0.766,respectively);the sensitivity,specificity,accuracy,positive predictive value,negative predictive value were(97.84%,88.81%,94.90%,94.77%,95.20%),respectively,higher than those of enhanced CT(89.88%,63.87%,80.10%,80.49%,79.20%)and enhanced MRI(94.87%,79.86%,89.81%,90.24%,88.80%)individual detection,the differences being statistically significant(P<0.05).The total detection rates of liver metastases of different diameters and locations,left and right lateral colonic primary lesions and liver metastases detected by enhanced CT combined with enhanced MRI(97.91%,97.91%,96.25%,98.26%)were higher than those detected by enhanced CT(68.29%,64.81%,68.75%,81.85%)and enhanced MRI(83.28%,82.23%,85.00%,89.20%)detected alone,the differences being statistically significant(P<0.05).Conclusion:Compared with individual detection,contrast enhanced CT combined with enhanced MRI can provide more accurate information on the

关 键 词：结直肠肿瘤 增强CT 增强MRI 肝转移 诊断效能 

分 类 号：R7353.34[医药卫生—肿瘤] R44[医药卫生—临床医学]