摘要
目的探讨动态增强核磁共振成像(MRI)与CT对乙型肝炎肝硬化背景下原发性肝癌的诊断价值。方法选择2017年7月至2020年5月在汕尾逸挥基金医院接受治疗的46例乙型肝炎肝硬化合并原发性肝癌患者为研究对象,所有患者均接受动态增强MRI及CT检查,以病理组织诊断结果为诊断标准,比较动态增强MRI及CT对乙型肝炎肝硬化背景下原发性肝癌病灶包膜边缘的强化表现、影像学表现和对病灶的检出率。结果 46例患者中检出病灶61个,小肝癌及大肝癌分别为19例和27例,病灶分别为22个和39个;动态增强MRI扫描显示原发性肝癌病灶包膜完整环状强化率为57.38%,明显高于动态增强CT的37.70%,差异有统计学意义(P<0.05);动态增强MRI扫描与CT扫描的原发性肝癌病灶包膜无明显强化率(26.23%vs 37.70%)和不完全环状强化率(16.39%vs 24.59%)比较,差异均无统计学意义(P>0.05);动态增强MRI动脉期高信号率为95.08%,明显高于动态增强CT的80.33%,差异有统计学意义(P<0.05);动态增强MRI对原发性小肝癌病灶的检出率为95.45%,明显高于动态增强CT的63.64%,差异有统计学意义(P<0.05);动态增强MRI对原发性大肝癌病灶的检出率为97.44%,与动态增强CT对原发性大肝癌病灶的检出率92.31%比较差异无统计学意义(P>0.05)。结论动态增强MRI及CT均可作为乙型肝炎肝硬化背景下原发性肝癌的诊断手段,但动态增强MRI更能清晰显示包膜强化和肝癌血供特点,在小肝癌诊断上更有优势。
Objective To explore the value of dynamic contrast-enhanced MRI and CT in the diagnosis of primary liver cancer in the context of hepatitis B cirrhosis. Methods The 46 patients with hepatitis B cirrhosis and primary liver cancer were selected as the study subjects, who received treatment at Shanwei Yifan Fund Hospital from July2017 to May 2020. All patients underwent dynamic contrast-enhanced MRI and CT examination. With the diagnosis of pathological tissues as the diagnostic criteria, dynamic contrast-enhanced MRI and CT were compared on the enhancement of the lesion capsule edge, imaging features and the detection rate of the primary liver cancer in the context of hepatitis B cirrhosis. Results In 46 patients, 61 lesions were detected, with 22 lesions in 19 cases of small liver cancer and39 lesions in 27 cases of large liver cancer. Dynamic contrast-enhanced MRI scans showed that the annular enhancement rate of intact capsule of primary liver cancer was 57.38%, which was significantly higher than 37.70% of dynamic contrast-enhanced CT scan, and the difference was statistically significant(P<0.05). Compared with CT scan, dynamic contrast-enhanced MRI scan had no obvious enhancement rate(26.23% vs 37.70%) and incomplete circular enhancement rate(16.39% vs 24.59%), and both differences were not statistically significant(P>0.05). The high signal rate of dynamic contrast-enhanced MRI in arterial phase was 95.08%, which was significantly higher than 80.33% of dynamic contrast-enhanced CT(P<0.05). The detection rate of dynamic contrast-enhanced MRI for primary small liver cancer was95.45%, which was significantly higher than 63.64% of dynamic contrast-enhanced CT for primary small liver cancer(P<0.05). The detection rate of dynamic contrast-enhanced MRI for primary large liver cancer was 97.44%, and there was no statistically significant difference from 92.31% of dynamic contrast-enhanced CT for primary large liver cancer(P>0.05). Conclusion Both dynamic contrast-enhanced MRI and CT can be used as diagnostic methods f
作者
游家生
吕秀金
郭伟娟
YOU Jia-sheng;LV Xiu-jin;GUO Wei-juan(Department of Medical Imaging,Shanwei Yifan Fund Hospital,Shanwei 516600,Guangdong,CHINA;CT/MR Room,Haifeng Pengpai Memorial Hospital,Shanwei 516600,Guangdong,CHINA)
出处
《海南医学》
CAS
2022年第1期79-82,共4页
Hainan Medical Journal
